Purpose

To report the electrophysiological and neuroimaging findings in a patient who developed visual loss after attempted suicide by hanging.

Methods

A 45-year-old male presented with bilateral visual loss and difficulty in walking following a suicide attempt by hanging six months ago. He underwent a complete ophthalmologic examination, posterior segment optical coherence tomography (OCT), various electrophysiological tests and neuroimaging.

Results

His bilateral best-corrected visual acuity was logMAR 1.08. Intraocular pressures and ocular examination were normal except for bilateral temporal disk pallor. Macular OCT showed bilateral ganglion cell layer-inner plexiform layer complex thinning. Electroretinogram showed reduced b/a wave amplitude ratio in all the dark- and light-adapted International Society for Clinical Electrophysiology of Vision protocols in both the eyes. Pattern-reversal visually evoked potential (VEP) showed delayed latency of the P100 component in both the eyes. Electrooculography showed a normal light peak-to-dark trough ratio in both the eyes.

Magnetic resonance imaging (MRI) brain showed chronic infarct and gliosis in both the occipital lobes. MR angiography showed pruning of P4 segments of both the posterior cerebral artery. Perfusion imaging showed reduction of perfusion in both the parieto-occipital lobes.

Conclusion

Hanging survivors can develop visual loss after their recovery. The visual loss may be a result of simultaneous ischemic insult to the occipital lobe cortex, optic nerve and retina.

中文翻译：

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一名试图通过上吊自杀后出现视力丧失的患者的电生理和神经影像学检查结果

目的

报告一名在试图通过上吊自杀后视力丧失的患者的电生理学和神经影像学检查结果。

方法

一名 45 岁男性在六个月前上吊自杀后出现双侧视力丧失和行走困难。他接受了完整的眼科检查、后段光学相干断层扫描 (OCT)、各种电生理测试和神经影像学检查。

结果

他的双侧最佳矫正视力为 logMAR 1.08。除双侧颞盘苍白外，眼压和眼科检查均正常。黄斑OCT显示双侧神经节细胞层-内丛状层复合体变薄。视网膜电图显示双眼的所有暗适应和光适应国际视觉临床电生理学会协议中的 b/a 波振幅比降低。模式反转视觉诱发电位 (VEP) 显示双眼中 P100 成分的延迟延迟。眼电图显示双眼的光峰暗谷比正常。

磁共振成像 (MRI) 大脑显示两个枕叶有慢性梗塞和神经胶质增生。MR 血管造影显示两个大脑后动脉的 P4 段均被修剪。灌注成像显示两个顶枕叶灌注减少。

结论

上吊的幸存者在康复后可能会出现视力丧失。视力丧失可能是枕叶皮层、视神经和视网膜同时缺血性损伤的结果。