Document Detail

Neuro-ophthalmic findings in the visual variant of Alzheimer's disease.
MedLine Citation:
PMID:  15019393     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To describe the clinical features of a visual variant Alzheimer's disease, a disorder that might be seen by the ophthalmologist with visual symptoms and signs. DESIGN: Retrospective case series. PARTICIPANTS: Eight patients with Alzheimer's disease presenting with predominantly visual complaints. METHODS: A retrospective review of patients at a tertiary care academic center seen by the authors from 1999 to 2001 with Alzheimer's disease and predominantly visual complaints. RESULTS: Eight patients with the visual variant of Alzheimer's disease were reviewed. All had seen eye care providers before referral to the neuro-ophthalmology clinic for visual complaints but without a diagnosis. Four patients had homonymous visual field loss, and two had presumed cortical visual impairment. Neuroimaging showed either normal brain (1 patient) or atrophy of the parietal or occipital areas but no structural lesions (7 patients). Fluoro-18-deoxyglucose positron emission tomography scans were performed in five of the cases, and all showed hypoperfusion in the parietooccipital areas. Neuropsychologic testing revealed visuospatial deficits in all 5 patients tested. CONCLUSIONS: Visual symptoms might be the presenting (or rarely only) manifestation of Alzheimer's disease. Clinicians should be aware of the visual variant of Alzheimer's disease. Neuropsychological testing and magnetic resonance imaging (MRI) provide supporting evidence for the diagnosis. Positron emission tomography scans might be helpful in selected cases, especially those with a normal MRI.
Andrew G Lee; Coleman O Martin
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Ophthalmology     Volume:  111     ISSN:  0161-6420     ISO Abbreviation:  Ophthalmology     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-15     Completed Date:  2004-03-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  376-80; discussion 380-1     Citation Subset:  IM    
Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
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MeSH Terms
Aged, 80 and over
Alzheimer Disease / diagnosis*
Blindness, Cortical / diagnosis
Fluorodeoxyglucose F18 / diagnostic use
Hemianopsia / diagnosis
Magnetic Resonance Imaging
Middle Aged
Neuropsychological Tests
Occipital Lobe / pathology
Parietal Lobe / pathology
Retrospective Studies
Tomography, Emission-Computed
Vision Disorders / diagnosis*
Visual Fields*
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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