Tohoku J. Exp. Med., 2016 April, 238(4)

Improvement of Glucose Metabolism in the Visual Cortex Accompanies Visual Field Recovery in a Patient with Hemianopia

YUKIHISA SUZUKI,^1,2,3 MOTOHIRO KIYOSAWA,^1,4 KEIICHI ODA,^2,5 KIICH ISHIWATA² and KENJI ISHII²

¹Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan
²Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
³Japan Community Health Care Organization, Mishima General Hospital, Mishima, Shizuoka, Japan
⁴Kiyosawa Eye Clinic, Tokyo, Japan
⁵Faculty of Health Science, Hokkaido University of Science, Sapporo, Hokkaido, Japan

Damage to the visual cortex or the geniculostriatal pathways could cause homonymous visual field (VF) defects at the contralateral side of the lesion. In clinical practice, it is known that the VF defects are gradually recovered over months on the cases. We report a case with recovered homonymous hemianopia following an infarction in the visual cortex by positron emission tomography (PET) with ¹⁸F-fluorodeoxyglucose (FDG) and ¹¹C-flumazenil (FMZ). A 58-year-old man experienced defect of left VF, and magnetic resonance imaging (MRI) revealed a localized infarction in the right occipital lobe. Goldmann VF perimetry revealed left homonymous hemianopia, but central VF was intact. Three months after the onset of infarction, we measured cerebral glucose metabolism with FDG and FMZ binding using PET. FMZ binding reflects the density of surviving neurons. Moreover, eight months after the onset, FDG-PET scan was performed. Goldmann VF perimetry was also performed at the same times of PET examinations. Decrease of cerebral glucose metabolism in the right anterior striate cortex was observed at three months after onset, while FMZ binding in the same area did not decrease in the patient. At eight months after onset, we observed recovery of VF and improvement of cerebral glucose metabolism in the anterior striate cortex. We presented change of cerebral glucose metabolism using PET accompanying improvement of VF. Evaluation of cerebral glucose metabolism and FMZ binding in the striate cortex is useful for estimating the prognosis of hemianopia caused by organic brain damage.

keywords —— homonymous hemianopia; positron emission tomography; recovery; striate cortex; visual field

© 2016 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2016, 238, 267-271

Correspondence: Yukihisa Suzuki, M.D., Ph.D., Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Yushima 1 chome-5-45, Bunkyo-ku, Tokyo 113-8519, Japan.

e-mail: suzuki@f8.dion.ne.jp