Ganglion Cell Atrophy and Optic Nerve Cupping in Patients with Postgeniculate Homonymous Visual Field Loss

There is increasing evidence for retrograde trans-synaptic degeneration (RTSD) in the retina following cortical injury, even in adults. Homonymous ganglion cell layer (GCL) thinning following postgeniculate injury, consistent with RTSD has recently been demonstrated,[1],[2],[3] but no funduscopic correlate has been demonstrated. Optic disc cupping has been attributed to RTSD following cortical ischemia in children with congenital periventricular leukomalacia[4]. We therefore hypothesized that cupping might accompany adult-onset RTSD.