At this junction…

Surv Ophthalmol. 2022 Nov-Dec;67(6):1711-1716. doi: 10.1016/j.survophthal.2021.08.001. Epub 2021 Aug 6.


An 81-year-old woman developed painful vision loss to hand motions in the right eye over a several-day period. Dilated fundus examination revealed no acute pathology, but automated perimetry showed a superotemporal visual field defect in the asymptomatic left eye, suggestive of a junctional defect. Magnetic resonance imaging demonstrated enhancement of the right optic nerve extending to its junction with the optic chiasm. The patient's vision failed to improve with intravenous corticosteroids, but demonstrated significant improvement with therapeutic plasma exchange. She was subsequently found to be seropositive for aquaporin-4 autoantibodies, confirming the diagnosis of neuromyelitis optic spectrum disorder.

Keywords: junctional scotoma; neuromyelitis optica spectrum disorder; optic neuritis; plasma exchange; retrobulbar optic neuropathy.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones
  • Aged, 80 and over
  • Aquaporin 4
  • Autoantibodies
  • Female
  • Humans
  • Optic Nerve
  • Optic Neuritis* / diagnosis


  • Adrenal Cortex Hormones
  • Aquaporin 4
  • Autoantibodies