At this junction…

Alexander M. Warwick, Sidney M. Gospe, John J. Chen

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
JournalSurvey of ophthalmology
StateAccepted/In press - 2022


  • junctional scotoma
  • neuromyelitis optica spectrum disorder
  • optic neuritis
  • plasma exchange
  • retrobulbar optic neuropathy

ASJC Scopus subject areas

  • Ophthalmology


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