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Submitted: 2025-03-12
DOI: 10.35119/myjo.v8i2.474
Case Reports
Published: 2026-06-22

Evidence of retrograde trans-synaptic degeneration: retinal ganglion cell atrophy following occipital stroke

Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
https://orcid.org/0000-0003-0463-5743
Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
https://orcid.org/0000-0002-1452-0141
occipital stroke retinal ganglion cells trans-synaptic degeneration

Abstract

Background: Trans-synaptic degeneration (TSD) is an uncommon phenomenon wherein the degeneration of one neuron leads to the subsequent degeneration of interconnected neurons.

Case report: A 50-year-old woman experienced sudden bilateral visual field loss for 10 days, accompanied by right-sided headache, numbness, tingling, and a sensation of tingling and heaviness in the tongue. The confrontation visual field indicated right homonymous hemianopia field loss, and automated static perimetry confirmed this finding. Magnetic resonance imaging showed recent acute infarcts on the left occipital lobe and optical coherence tomography of the ganglion cell layer revealed contralateral thinning, thus confirming retrograde TSD, as the post-synaptic damage in the occipital lobe was mirrored in the pre-synaptic neurons, i.e., ganglion cells.

Conclusion: This case report demonstrated evidence of TSD in the retinal ganglion cell layer of a patient with acute occipital stroke.