Blindness or Agnosia: Review of Posterior Cortical Atrophy and a Difficult Case

The Objective was to brie fly review the rare condition Posterior Cortical Atrophy (PCA) and demonstrate a difficult case suffering from both visual disturbances due to glaucoma and visual agnosia due to PCA. The short review was made by Pub Med search including “Posterior Cortical Atrophy” and the reference lists from the obtained articles were scrutinized for relevant literature not retrieved from PubMed. PCA is a slowly progressing neurodegenerative disorder that is very disabling due to disturbances of higher visual functions, although memory might be relatively preserved until late in the course. Some previous authors have underscored, that to diagnose a patient with PCA one must rule out that the patient is suffering from an eye disease. We demonstrate a difficult case suffering from both glaucoma and PCA. The diagnostic characteristics for PCA are described, and neuroimaging including positron emission tomography (PET) with the amyloid binding ligand (11C) Pittsburgh compound B (PiB), and results from treatment of PCA are presented. Caution should be advised when patients with impaired visual acuity develop signs of cognitive dysfunction, and a full neuropsychological examination should be performed whenever there is doubt of the significance of visual impairment and impaired visuospatial functions. doi:10.4021/jnr91w