Isolated Homonymous Hemianopia

Abstract

In a retrospective review of 104 cases of homonymous hemianopia, cerebral infarction was the diagnosis in 89% of the patients. This diagnosis was twice as common as reported in a previous series, which included other neurologic findings along with homonymous field defects. The majority of patients were white and between the ages of 50 and 70 years, often having a history of vascular disease. Eighty-eight percent of the patients showed a static or improved clinical course, while only 12% showed visual field or central nervous system deterioration. A routine work-up, excluding contrast studies, was sufficient to select 11 out of the 12 cases that were not due to infarction. Data that were suggestive of a noninfarctive cause were patients aged under 40 years, incongruous field defects, abnormal skull x-ray films, abnormal opticokinetic nystagmus, and elevated levels of spinal fluid protein.