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Show Journal of Neiiiv- Ophllwlnmlogy 19( 3): 217, 1999. © 1999 Lippincotl Williams & Wilkins, Inc., Philadelphia Letter to the Editor To the Editor: Turbin et al. ( 1) reported an 11- year- old boy with decreased visual acuity, a left afferent pupillary defect, temporal hemianopic visual field loss in the left eye only, and monocular band optic atrophy. The authors described the possible topographic localization for a lesion causing such findings. H. M. Traquair previously had used the term " junction scotoma" to refer to a monocular temporal hemicentral field defect caused by compression of the nasal fibers crossing at the junction of the intracranial optic nerve and optic chiasm. Miller has emphasized that this junction scotoma is different from the more commonly used term, " junctional scotoma" ( an ipsilateral optic neuropathy and a contralateral superotemporal defect). To differentiate these two junctional visual field defects, J. Lawton Smith proposed that the strictly unilateral temporal visual field defect described by Traquair be called the ' junctional scotoma of Traquair' to distinguish this defect from the contralateral superotemporal defect referred to as the junctional scotoma ( 2). I wonder if the authors could comment on whether their findings represent a noncompressive junctional scotoma of Traquair. Perhaps the authors have added a newly recognized ( or at least underemphasized) finding ( monocular band atrophy) to the criteria for this type of junctional visual field loss. I, for one, will be looking more closely at the type of atrophy in the optic nerve in future cases of monocular hemianopic visual field loss. Andrew G. Lee, MD Houston, Texas REFERENCES 1. Turgin RE, St. Louis L, Barr D, Kupersmith MJ. Monocular band atrophy. J Neuro- opthalmol 1998; 18: 242- 5. 2. Miller NR. Topical diagnosis of lesions in the visual sensory pathway. In: Wlash and Hoyt'. s Clinical Neuro- ophthalmology. 5th ed. Baltimore: Williams & Wilkins, 1998: 296. |