This Hoyt lecture is composed of 2 topics. First, a series of patients with idiopathic intracranial hypertension (IIH) is presented, emphasizing the importance of magnetic resonance venography (MRV). Study of the cerebral venous sinuses in IIH may demonstrate focal stenosis or venous gaps and represent a manifestation of elevated intracranial pressure. Conversely, the clinical picture of IIH may occur following cerebral venous sinus thrombosis, and MRV may be essential in establishing this diagnosis. In the future, evaluation of flow in the cerebral venous sinuses may play an important role in determining the potential for visual failure. Second, I will review patients with visual cognitive changes, which often go unrecognized. These patients suffer from visuoperceptual disturbances, recognizing parts of visual scenes but not the entire picture and are unable to comprehend their visual environment. These findings are often part of the syndrome of posterior cortical atrophy characterized by parieto-occipital atrophy, enlargement of the atrial portion of the ventricular system, and diminished metabolic activity in the posterior portion of the brain demonstrated with positron emission tomography.
Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
William Fletcher Hoyt, MD, received his medical education at the University of California, San Francisco (UCSF) followed by a year's study at the Wilmer Institute, Johns Hopkins University, under the mentorship of Frank B. Walsh, MD. Dr. Hoyt returned to UCSF in 1958 to found the neuro-ophthalmology service. During a 36-year academic career-all of it at UCSF-he authored 266 journal articles, co-authored (with Frank B. Walsh, MD) the third edition of Clinical Neuro-Ophthalmology, and trained 71 neuro-ophthalmology fellows. In 1983 he received the title of Honorary Doctor of Medicine from the Karolinska Institute. Currently he serves as Professor Emeritus of Ophthalmology, Neurology, and Neurosurgery at UCSF. In recognition of his contributions, in 2001 the North American Neuro-Ophthalmology Society (NANOS), in conjunction with the American Academy of Ophthalmology, initiated the Hoyt Lecture to be delivered each year at the Annual Meeting of the American Academy of Ophthalmology.
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The author declares no conflict of interest.
Address correspondence to Norman J. Schatz, MD, 4701 N. Meridian Avenue, Adams Building, Suite 500A, Miami Beach, FL 33140; E-mail: email@example.com