Is a Macula Only Homonymous Hemianopsia usually caused by a compressive tumor or a stroke?

Macula Only Homonymous Hemianopsia is primarily associated with lesions affecting the visual pathways specifically at the level of the optic radiations that correspond to the macular region. This type of visual field defect is often seen with lesions caused by compressive tumors, such as pituitary adenomas, which can exert pressure on the optic chiasm or optic radiations, leading to localized visual field loss that spares the peripheral vision but affects the central vision involved with macular function.

In contrast, stroke commonly results in more generalized visual field deficits, including complete homonymous hemianopsia rather than isolated macula-only deficits. Strokes generally affect a broader area of the visual system and are less likely to specifically spare the central vision as seen in cases of macula only defects. Therefore, while strokes can lead to various visual field abnormalities, they do not typically present with a macula only pattern.

Additionally, other conditions like neurodegenerative diseases or retinal issues can also lead to changes in visual field perception but are not classified under homonymous hemianopsia in a macular-specific presentation. Thus, the relationship between compressive tumors and macula only homonymous hemianopsia underscores that these tumors are the most likely underlying pathology in such