Arcuate scotoma is a type of scotoma extending from the blind spot and arching into the nasal field following the lines of retinal nerve fibers.

Types

  • An arcuate scotoma may be relative or absolute.
  • In the temporal portion of the field, it is narrow because all of the nerve fiber bundles converge onto the optic nerve.
  • The scotoma spreads out on the nasal side and may be very wide along the horizontal meridian.

Differential Diagnosis

If there is an arcuate scotoma there must be a notch.

  • Prelaminar
    • Optic disc drusen
    • Papilledema
  • Laminar
    • Ischaemic optic neuropathy
  • Optic canal
    • Infiltrative, meningioma, demyelination, inflammatory mass
    • Intracanalicular
    • Arterial

Imaging

Generally an MRI will be helpful (contrast, fat suppression, T1).