A case of multiple sclerosis with homonymous hemianopia examined by positron emission tomography

Background: To demonstrate the efficacy of positron emission tomography (PET) for examining multiple sclerosis (MS) patients with hemianopia. Case: A 20-year-old man visited us with a complaint of left homonymous hemianopia and headache. Observations: The patient's visual acuity was 1.2 (n.c.) OD and 0.9 (1.0) OS. Magnetic resonance imaging (MRI) showed a mass in the temporoparietal lobe. A pathological diagnosis of MS was made by brain biopsy. Low glucose metabolism in the lesion and visual cortex was observed by PET with F-18-fluorodeoxy glucose. PET with C-11-flumazenyl revealed a reduction of C-11-uptake in the demyelinated optic radiation, and only a slight reduction of C-11-uptake in the primary visual cortex. The results of C-11-flumazenyl PET suggested a slight reduction of neuronal density. In 2 years, the visual field recovered to the normal state. Conclusion: PET can be a useful tool for estimating the visual outcome of patients with hemianopia in MS. (C) Japanese Ophthalmological Society 2004.