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Homonymous hemianopia as the presenting sign of posterior cortical atrophy
  1. Edward Margolin,
  2. Laura Donaldson
  1. Department of Ophthalmology and Vision Science, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Edward Margolin, Department of Ophthalmology and Vision Science, University of Toronto, Toronto, Ontario, Canada; Edward.margolin{at}

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A 56-year-old man reported 1 year of progressive decline in the vision of both eyes, left more than right. He had difficulty explaining his symptoms. Although he could clearly see the letters of text when reading, he struggled to verbalise and understand the content. He took amitriptyline and sertraline for anxiety and depression. Visual acuity was 6/12 (20/40) in each eye with normal ocular examination. He read simple material in a slow, halting fashion and made several errors. He scored 20/30 on mini-mental state examination. Formal visual field testing identified an incongruous left homonymous defect with good reliability (figure 1A).

Figure 1

Homonymous field defect in posterior cortical atrophy. (A) 24-2 Humphrey visual fields showing left homonymous field defect. MR scan of the brain showing no structural lesion, only mild posterior atrophy with prominent sulci within …

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  • Contributors Both authors contributed equally to manuscript preparation, data gathering, final approval of the manuscript and finalising of the edited version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned. Externally peer reviewed by Christian Lueck, Canberra, Australia.

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