scholarly journals Visual Field Defect after Cardiac Surgery: The Striking Role of Interdisciplinary Collaboration

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Raffaele Nuzzi ◽  
Carlo Lavia
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Interdisciplinary Collaboration ◽  
Visual Fields ◽  
Cortical Blindness ◽  
Visual Field Defects ◽  
Ischemic Optic Neuropathy ◽  
Intraoperative Hypotension ◽  
Perioperative Visual Loss ◽  
Vascular Occlusions

Perioperative visual loss (POVL) is a potentially devastating complication that can occur following ocular or nonocular surgery. The leading causes of this disease are retinal vascular occlusions, ischemic optic neuropathies, and cortical blindness. POVL pathogenesis is strictly influenced by surgery, anesthesia, and patients’ comorbidities. We report of a 55-year-old caucasian man who presented with complaints of sudden painless loss of vision and unilateral campimetric deficit. We recorded a preserved visual acuity but at fundus examination a bilateral ischemic optic neuropathy (ION) was suspected. Our hypothesis was supported by uncommon and peculiar visual field defects and a history of cardiovascular surgery shortly before was a striking data. When we examined his medical records we found strong accordance with what is reported in literature to be risk factors for postoperative ION development. He presented intraoperative hypotension, anemia, and hypothermia, he was older than 50 years, and surgery lasted for more than five hours. We are currently monitoring his visual acuity and visual fields which remain unchanged. As there is no proved therapy for such severe adverse events, we recommend intraoperative check of blood pressure, blood loss, and body temperature, associated with repeated eye checks and patients’ interview.

Arteriovenous malformations in the optic apparatus: systematic literature review and report of four cases

2021 ◽  
pp. 1-11
Author(s):  
Visish M. Srinivasan ◽  
Phiroz E. Tarapore ◽  
Stefan W. Koester ◽  
Joshua S. Catapano ◽  
Caleb Rutledge ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Function ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Visual Fields ◽  
Optic Tract ◽  
Visual Disturbance ◽  
Visual Field Defects ◽  
Subtotal Resection

OBJECTIVE Rare arteriovenous malformations (AVMs) of the optic apparatus account for < 1% of all AVMs. The authors conducted a systematic review of the literature for cases of optic apparatus AVMs and present 4 cases from their institution. The literature is summarized to describe preoperative characteristics, surgical technique, and treatment outcomes for these lesions. METHODS A comprehensive search of the English-language literature was performed in accordance with established Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all published cases of AVM in the optic apparatus in the PubMed, Web of Science, and Cochrane databases. The authors also searched their prospective institutional database of vascular malformations for such cases. Data regarding the clinical and radiological presentation, visual acuity, visual fields, extent of resection, and postoperative outcomes were gathered. RESULTS Nine patients in the literature and 4 patients in the authors’ single-surgeon series who fit the inclusion criteria were identified. The median age at presentation was 29 years (range 8–39 years). Among these patients, 11 presented with visual disturbance, 9 with headache, and 1 with multiple prior subarachnoid hemorrhages; the AVM in 1 case was found incidentally. Four patients described prior symptoms of headache or visual disturbance consistent with sentinel events. Visual acuity was decreased from baseline in 10 patients, and 11 patients had visual field defects on formal visual field testing. The most common visual field defect was temporal hemianopia, found in one or both eyes in 7 patients. The optic chiasm was affected in 10 patients, the hypothalamus in 2 patients, the optic nerve (unilaterally) in 8 patients, and the optic tract in 2 patients. Six patients underwent gross-total resection; 6 patients underwent subtotal resection; and 1 patient underwent craniotomy, but no resection was attempted. Postoperatively, 9 of the patients had improved visual function, 1 had no change, and 3 had worse visual acuity. Eight patients demonstrated improved visual fields, 1 had no change, and 4 had narrowed fields. CONCLUSIONS AVMs of the optic apparatus are rare lesions. Although they reside in a highly eloquent region, surgical outcomes are generally good; the majority of patients will see improvement in their visual function postoperatively. Microsurgical technique is critical to the successful removal of these lesions, and preservation of function sometimes requires subtotal resection of the lesion.

scholarly journals The anterior ischemic optic neuropathy treatment using the dispersed “Alloplant”

2013 ◽  
Vol 6 (2) ◽  
pp. 20-24
Author(s):  
Venera Uzbekovna Galimova ◽  
Irina Viktorovna Verzakova ◽  
Yevgeniy Musinovich Gareyev ◽  
Zarina Khikhmetullovna Karimova
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Blood Supply ◽  
Optic Neuropathy ◽  
Visual Fields ◽  
Resistance Index ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Ciliary Arteries ◽  
Lateral Branches

In this article, the results of a study are presented on the influence of the therapeutic retroscleral filling by dispersed “Alloplant” biomaterial upon blood supply and visual functions of the eye. 47 patients (69 eyes) suffering from anterior ischemic optic neuropathy sequelae were examined. Obtained results allowed to study the degree of relationship between the following indices: resistance index of ocular vessels, visual acuity and electrophysiological data, visual field limits. The majority of cases with significant visual fields widening (79 %) correlated with post-operative decrease of resistance index in posterior short ciliary arteries (medial and lateral branches). The results of performed investigation allow to assume that the dispersed “Alloplant” biomaterial use in the treatment of patients with anterior ischemic optic neuropathy sequelae could promote the optic nerve blood supply improvement with further amelioration of visual function indices.

Visual Recovery after Transsphenoidal Removal of Pituitary Adenomas

Neurosurgery ◽  
1985 ◽  
Vol 17 (3) ◽  
pp. 446-452 ◽  
Author(s):  
Alan R. Cohen ◽  
Paul R. Cooper ◽  
Mark J. Kupersmith ◽  
Eugene S. Flamm ◽  
Joseph Ransohoff
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Diabetes Insipidus ◽  
Pituitary Adenomas ◽  
Visual Fields ◽  
Visual Field Defects ◽  
Duration Of Symptoms ◽  
Patients Âgés ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Field Defects

Abstract We reviewed the records of 100 consecutive patients with histologically verified pituitary adenomas who underwent transsphenoidal decompression of the optic nerves and chiasm. The patients' ages ranged from 18 to 80 years, with a median of 52 years. Preoperatively, all patients had objective signs of visual acuity or field defects. Postoperatively, visual acuity was normal or improved in 79% of the eyes and the visual fields were normal or improved in 74%. The visual outcome (for both acuity and fields) was better in younger patients and those with a shorter duration of symptoms. Patients with lesser degrees of preoperative visual acuity compromise had better postoperative visual acuity outcome. However, the severity of preoperative visual field defects did not seem to predict postoperative field outcome, and even patients with severe preoperative field defects often had striking postoperative improvement. Patients who had undergone prior operation were less likely to have either visual acuity or visual field improvement after reoperation. Postoperative deterioration in visual acuity was noted in only 5 patients (6 eyes). Complications were few. There were 4 instances of cerebrospinal fluid rhinorrhea, but only 2 patients needed operative repair. There was no instance of permanent diabetes insipidus, although 17 patients developed transient diabetes insipidus. In most cases, visual improvement was sustained. The average duration of follow-up was 26 months. Three patients required a subsequent operation to correct visual loss in the immediate postoperative period, but only 1 patient has undergone late operation for recurrence of tumor. There was no operative mortality.

Distracted Driving and Driving Patterns in Older Drivers With Glaucoma

2021 ◽  
pp. 155982762110428
Author(s):  
Purva Jain ◽  
Jonathan T. Unkart ◽  
Fabio B. Daga ◽  
Linda Hill
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Fields ◽  
Distracted Driving ◽  
Night Vision ◽  
Driving Ability ◽  
Safe Driving ◽  
Ability To Drive ◽  
Acuity Score

Limited research exists examining self-perceived vision and driving ability among individuals with glaucoma, and this study assessed the relationship between glaucoma, visual field, and visual acuity with driving capability. 137 individuals with glaucoma and 75 healthy controls were asked to evaluate self-rated vision, self-perceived driving ability, and self-perceived distracted driving. Visual acuity and visual field measurements were also obtained. Multivariable linear regressions were run to test each visual measure with driving outcomes. The average age was 72.2 years, 57.3% were male, and 72.5% were White. There were significant associations for a one-point increase in visual field and quality of corrected vision (RR = 1.06; 95% CI = 1.03–1.10), day vision (RR = 1.05; 95% CI = 1.03–1.08), night vision (RR = 1.08; 95% CI = 1.05–1.13), visual acuity score and higher quality of corrected of vision (RR = .41; 95% CI = .22-.77), day vision (RR = .39; 95% CI=.22–.71), and night vision (RR = .41; 95% CI = .18–.94); visual acuity score and ability to drive safely compared to other drivers your age (RR = .53; 95% CI = .29–.96). Individuals with poorer visual acuity and visual fields rate their vision and ability to drive lower than those with better vision, and this information will allow clinicians to understand where to target interventions to enhance safe driving practices.

Influence of Carteolol and Timolol on IOP and Visual Fields in Glaucoma: A Multi-Center, Double-Masked, Prospective Study

1992 ◽  
Vol 2 (4) ◽  
pp. 169-174 ◽  
Author(s):  
J. Flammer ◽  
Y. Kitazawa ◽  
L. Bonomi ◽  
B. Mills ◽  
M. Fsadni ◽  
...  
Keyword(s):  
Visual Field ◽  
Prospective Study ◽  
Beta Blockers ◽  
Visual Fields ◽  
Visual Field Defects ◽  
Eye Drops ◽  
Treatment Groups ◽  
Visual Field Damage ◽  
One Year ◽  
Field Defects

The influences of Carteolol and Timolol eye drops on intraocular pressure (IOP) and visual fields were compared in a multi-center, double-masked, prospective study. Two-hundred and forty eyes of 120 patients were initially included in the study, and 142 eyes of 72 patients fulfilled all the criteria for final statistical analysis. Both drugs significantly reduced IOP. The visual fields in both treatment groups did not change during one year of treatment. In both groups some patients improved slightly, and others deteriorated slightly. This indicates that locally applied beta-blockers may efficiently stop further progression of visual field defects in cases with increased IOP and early visual field damage. There was no difference between Carteolol and Timolol in this regard. The side effects were minimal, and there were no differences in their frequency or intensity in the two treatment groups.

Neuro-ophthalmology: Disorders of Visual Perception, Pupils, and Eyelids

2021 ◽  
pp. 821-833
Author(s):  
Shivram Kumar ◽  
Kelly D. Flemming
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Perception ◽  
Visual Loss ◽  
Visual Field Defects ◽  
Clinical Disorders ◽  
Physical Findings ◽  
Abnormal Visual ◽  
Visual Changes ◽  
Field Defects

Visual loss may develop acutely, subacutely, or insidiously. The course may be transient, static, or progressive. This chapter reviews the causes, diagnosis, and treatment of various disorders resulting in visual loss or abnormal visual perception. In addition, it reviews clinical disorders of the eyelids and pupils. Disorders of visual perception involve visual acuity, color perception, visual field defects, and other visual changes. Historical information and physical findings on examination can help to localize the problem and define the cause.

Optical Coherent Tomography Predicts Long-Term Visual Outcome of Pituitary Adenoma Surgery: New Perspectives From a 5-Year Follow-up Study

Neurosurgery ◽  
2020 ◽  
Vol 88 (1) ◽  
pp. 106-112 ◽  
Author(s):  
Young Soo Chung ◽  
Minkyun Na ◽  
Jihwan Yoo ◽  
Woohyun Kim ◽  
In-Ho Jung ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Visual Field ◽  
Assessment Tool ◽  
Visual Fields ◽  
Visual Field Defects ◽  
Mean Deviation ◽  
Rnfl Thickness ◽  
Long Term Follow Up

Abstract BACKGROUND Compressive optic neuropathy is the most common indication for transsphenoidal surgery for pituitary adenomas. Optical coherence tomography (OCT) is a useful visual assessment tool for predicting postoperative visual field recovery. OBJECTIVE To analyze visual parameters and their association based on long-term follow-up. METHODS Only pituitary adenoma patients with abnormal visual field defects were selected. A total of 188 eyes from 113 patients assessed by visual field index (VFI) and 262 eyes from 155 patients assessed by mean deviation (MD) were enrolled in this study. Postoperative VFI, MD, and retinal nerve fiber layer (RNFL) thickness were evaluated and followed up. After classifying the patients into normal (&gt;5%) and thin (&lt;5%) RNFL groups, we investigated whether preoperative RNFL could predict visual field outcomes. We also observed how RNFL changes after surgery on a long-term basis. RESULTS Both preoperative VFI and MD had a linear proportional relationship with preoperative RNFL thickness. Sustained improvement of the visual field was observed after surgery in both groups, and the degree of improvement over time in each group was similar. RNFL thickness continued to decrease until 36 mo after surgery (80.2 ± 13.3 μm to 66.6 ± 11.9 μm) while visual field continued to improve (VFI, 61.8 ± 24.5 to 84.3 ± 15.4; MD, −12.9 ± 7.3 dB to −6.3 ± 5.9 dB). CONCLUSION Patients with thin preoperative RNFL may experience visual recovery similar to those with normal preoperative RNFL; however, the probability of normalized visual fields was not comparable. RNFL thickness showed a strong correlation with preoperative visual field defect. Long-term follow-up observation revealed a discrepancy between anatomic and functional recovery.

Reading with Visual Field Defects

Perception ◽  
1997 ◽  
Vol 26 (1_suppl) ◽  
pp. 11-11 ◽  
Author(s):  
S Trauzettel-Klosinski
Keyword(s):  
Eye Movements ◽  
Visual Field ◽  
Reading Ability ◽  
Reading Speed ◽  
Visual Fields ◽  
Zero Point ◽  
Normal Subjects ◽  
Visual Field Defects ◽  
Video Tape ◽  
Field Defects

The influence of different visual field defects on the reading performance was examined with potential adaptive strategies to improve the reading process in mind. By means of an SLO, the retinal fixation locus (RFL) was determined with the use of single targets and text, and eye movements scanning the text were recorded on video tape. Additionally, eye movements were monitored by an Infrared Limbus Tracker. Visual fields were assessed by the Tübingen Manual and/or automatic perimetry. Normal subjects, and patients with central scotomata, ring scotomata, and hemianopic field defects (HFD) were examined. The main pathological reading parameters were an increase of saccade frequency and regressions per line, and a decrease of reading speed. In patients with field defects involving the visual field centre, fixation behaviour is significant for regaining reading ability. In absolute central scotoma, the lost foveal function promotes eccentric fixation. The remaining problem is insufficient resolution of the RFL, which can be compensated for by magnification of the text. In patients with insufficient size of their reading visual field, due to HFD and ring scotoma, it is crucial that they learn to use a new RFL despite intact foveolar function. Preconditions for reading have been found to be: (1) sufficient resolution of the RFL, (2) a reading visual field of a minimum extent, and (3) intact basic oculomotor function. In patients with visual field defects involving the centre, a sensory-motor adaptation process is required: the use of a new RFL as the new centre of the visual field and as the new zero point for eye-movement coordinates.

Influence of Nifedipine on the Visual Fields of Patients with Optic-Nerve-Head Diseases

1994 ◽  
Vol 4 (1) ◽  
pp. 24-28 ◽  
Author(s):  
A.Z. Gaspar ◽  
J. Flammer ◽  
PH. Hendrickson
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Optic Nerve Head ◽  
Channel Blocker ◽  
Glaucoma Patient ◽  
Visual Fields ◽  
Visual Field Defects ◽  
Channel Blockers

Calcium-channel blockers have long been employed in coronary disease, and recent investigations have indicated their efficacy in improving the visual field in low-tension glaucoma or presumed vasospasm, possibly by enhancing ocular circulation. We evaluated the short-term influence of a typical calcium-channel blocker, nifedipine, on 59 patients with visual-field defects, some with optic-nerve-head pathology (n = 38) and some with normal-appearing optic nerve heads (n = 21). On the average, a statistically significant improvement of 1.2 dB was observed. Different types of patients, however, behaved quite differently. The younger the patient, the greater the improvement. Patients with normal optic nerve heads improved by 1.54 dB, whereas patients with optic-nerve-head excavation improved by only 0.66 dB. No response was observed in patients with anterior ischemic neuropathy. Marked deterioration was noted in one glaucoma patient with low systemic blood pressure. The visual-field changes were observed in the scotomatous and non-scotomatous areas. Thus, the calcium-channel blocker nifedipine can be effective in some selected diseases whose pathogenesis probably involves vascular dysregulation though it may even be contraindicated in others

scholarly journals Chromatic Pupilloperimetry Measures Correlate With Visual Acuity and Visual Field Defects in Retinitis Pigmentosa Patients

2020 ◽  
Vol 9 (8) ◽  
pp. 10
Author(s):  
Ifat Sher ◽  
Yisroel Tucker ◽  
Maya Gurevich ◽  
Amit Hamburg ◽  
Ettel Bubis ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Retinitis Pigmentosa ◽  
Visual Field Defects ◽  
Field Defects
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