{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T04:34:31Z","timestamp":1768883671370,"version":"3.49.0"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,2,9]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>A 78-year-old man with vascular risk factors and a family history of glaucoma presents with bilateral superior arcuate visual field loss. MRI brain was reported normal. Intraocular pressure (IOP) and optical coherence tomography of the retinal nerve fibre layer (RNFL) were within normal limits. A tentative diagnosis of normal tension glaucoma was made. Over the next 5\u2009years, IOP remained stable without treatment, serial visual fields noted repeatable bilateral superior depressions with normal RNFL. Referral to a glaucoma subspecialist and subsequently neuro-ophthalmologist prompted repeat MRIs, which demonstrated mild small vessel ischaemia. Standard visual evoked potentials (VEPs) were normal. Multifocal VEPs identified poor response across the entire visual field in both eyes. The combination of visual defects, unremarkable RNFL and reduced multifocal VEPs raised suspicion of bilateral inferior calcarine fissure change. Retrospective review of MRI\u2019s in a multidisciplinary meeting confirmed extensive microvascular changes with bilateral inferior calcarine fissure ischaemia.<\/jats:p>","DOI":"10.1136\/bcr-2018-227803","type":"journal-article","created":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T06:44:08Z","timestamp":1553237048000},"page":"e227803","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["When \u2018glaucomatous fields\u2019 are not glaucoma: bilateral calcarine fissure strokes masquerading as glaucoma in a normal tension glaucoma suspect"],"prefix":"10.1136","volume":"12","author":[{"given":"Nayomi","family":"Perera","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Parke Street Medical Centre, Katoomba, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Shields","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Parke Street Medical Centre, Katoomba, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlon","family":"Perera","sequence":"additional","affiliation":[{"name":"Department of Urology, Royal Brisbane and Women\u2019s Hospital, Herston, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Parke Street Medical Centre, Katoomba, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,21]]},"reference":[{"key":"2025082802151513000_12.3.e227803.1","first-page":"138","article-title":"Visual field defects","volume":"24","author":"Jay","year":"1981","journal-title":"Am Fam Physician"},{"key":"2025082802151513000_12.3.e227803.2","first-page":"690","article-title":"Bilateral occipital lobe stroke with inferior altitudinal defects","volume":"71","author":"Holt","year":"2000","journal-title":"Optometry"},{"key":"2025082802151513000_12.3.e227803.3","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1471-2261-10-14","article-title":"Bilateral occipital lobe infarction with altitudinal field loss following radiofrequency cardiac catheter ablation","volume":"10","author":"Luu","year":"2010","journal-title":"BMC Cardiovasc Disord"},{"key":"2025082802151513000_12.3.e227803.4","doi-asserted-by":"crossref","unstructured":"Walsh T . 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American academy of ophthalmology. 2016 http:\/\/www.aao.org\/eyenet\/article\/diagnosis-treatment-of-normal-tension-glaucoma?february-2007."},{"key":"2025082802151513000_12.3.e227803.12","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1159\/000355024","article-title":"Magnetic resonance imaging versus computed tomography in transient ischemic attack and minor stroke: The more \u03c5ou see the more you know","volume":"3","author":"Moreau","year":"2013","journal-title":"Cerebrovasc Dis Extra"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-227803","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:15:26Z","timestamp":1756372526000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-227803"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,21]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bcr-2018-227803"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-227803","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}