An unusual cause of blindness: infarction in the bilateral lateral geniculate bodies

Clinical characteristics and risk factors for bilateral lateral geniculate body pathology: a systematic review of the literature

BACKGROUND

Case presentation of acute onset bilateral painless vision loss caused by bilateral infarction of the lateral geniculate bodies (LGB) and a systematic review of the literature.

METHODS

A descriptive case report is presented on a 17-year-old female diagnosed with acute pancreatitis who developed acute onset bilateral painless vision loss. A systematic literature review of cases with bilateral LGB lesions was conducted across three electronic databases (PubMed/PubMed Central/MEDLINE, Scopus, and ScienceDirect). The review was conducted in concordance with PRISMA guidelines and prospectively registered on PROSPERO (CRD42022362491).

RESULTS

The reported 17-year-old female was found to have MRI findings consistent with bilateral hemorrhagic infarction of the LGB and Purtscher-like retinopathy. A systematic literature review of bilateral LGB infarction yielded 23 records for analysis. 19/23 (82.6%) of reported cases occurred in women. Bilateral vision loss was noted in all cases. The average reported age was 27 years old with a range from 2-50. Gastrointestinal pathology (e.g., pancreatitis, gastroenteritis) was present in 8/23 (34.7%) of cases. 8/23 (34.7%) cases had neuroimaging or pathological evidence of hemorrhagic transformation of the infarct. Most cases experienced partial recovery of visual loss; only one case (4.7%) had complete visual recovery. 9/23 (39.1%) cases were reported from the United States and 4/23 (17.3%) from India.

CONCLUSIONS

Bilateral LGB lesion is a rare cause of vision loss, typically caused by systemic diseases and with female preponderance. Purported pathophysiology relates to increased vulnerability of the LGB to ischemic and metabolic stress.

Bilateral Retinal and Lateral Geniculate Nucleus Infarction in an Adolescent With Influenza

We describe a 13-year-old female with influenza complicated by bilateral vision loss due to retinal and lateral geniculate nucleus (LGN) infarctions. She continues to have near-total vision loss in her left eye 3.5 years later. This is the second reported case of bilateral retinal and LGN infarctions in the setting of influenza. The mechanism of infarction remains to be determined, but it is important to recognize this entity and counsel patients appropriately as visual recovery may be poor.

Loss of Vision Because of Bilateral Lateral Geniculate Body Infarction After Traumatic Brain Injury

In TBI patients, LPG infarction as a consequence of descending transtentorial herniation should be considered as a possible etiology of bilateral blindness.

Eyes and stroke: the visual aspects of cerebrovascular disease

A large portion of the central nervous system is dedicated to vision and therefore strokes have a high likelihood of involving vision in some way. Vision loss can be the most disabling residual effect after a cerebral infarction. Transient vision problems can likewise be a harbinger of stroke and prompt evaluation after recognition of visual symptoms can prevent future vascular injury. In this review, we discuss the visual aspects of stroke. First, anatomy and the vascular supply of the visual system are considered. Then, the different stroke syndromes which involve vision are discussed. Finally, topics involving the assessment, prognosis, treatment and therapeutic intervention of vision-specific stroke topics are reviewed.