Abstract
We present the cases of two patients with unilateral compressive optic neuropathy and homonymous hemianopia following intracranial hemorrhage. Patient 1 was a 43-year-old man. He had aphasia, right hemiplegia, and left conjugate deviation and underwent craniotomy for left putaminal hemorrhage with midline shift on computed tomography. Four months after onset, visual acuity was 1.0 in the right eye and 0.6 in the left. Relative afferent pupillary defect（RAPD）was present in the left eye. Right quadrantanopia was detected by visual field test. Optic nerve atrophy in the left eye was observed. Ganglion cell complex（GCC）thickness on optical coherence tomography was 89.9 μm in the right eye and 73.1μm in the left with thinning around the fovea. Subsequently, GCC thickness in both eyes reduced gradually and progressively in the area, consistent with homonymous hemianopia. Patient 2 was a 72-year-old woman. She had headache, left hemiplegia, disturbance of consciousness and dysarthria and underwent endoscopic hematoma removal for right temporal lobe subcortical hemorrhage with midline shift on magnetic resonance imaging. Three months after onset, visual acuity was 0.2 in the right eye and 0.5 in the left. RAPD was present in the right eye. Optic nerve atrophy in the right eye was observed. GCC thickness was 71.3 μm in the right eye with thinning around the fovea and 94.3μm in the left. In patients with intracerebral hemorrhage with midline shift, direct compression or cerebral edema due to hematoma may cause compression of the intracranial optic nerve, leading to unilateral simple optic atrophy.
