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R Lorance

Publications and source records attributed to R Lorance.

2 recordsLinked to original sources

Optic neuritis: a prospective study.

We studied 20 patients with acute optic neuritis prospectively for 12 months. Visual fields, color vision, and VEPs to 15' checks were initially abnormal in all patients. Visual acuity was abnormal in 90% and contrast sensitivity in 95% of patients. We devised a graded visual impairment scale (GVIS) to include all visual functions tested. Complete recovery of visual function occurred in 65% of cases. Recovery in the majority of patients was rapid and complete within the first 2 months. In some patients, improvement continued over 6 months. The initial classification on the GVIS was significantly correlated with the final outcome. Patients initially classified as having moderate visual impairment recovered completely or improved to near normal vision. Sixty percent of patients initially classified as total or severe blindness had permanent visual impairment. VEP latency remained prolonged in 19 patients, even when their vision had returned to normal, and is a reliable indicator of resolved optic neuritis.

Adult

Saccadic latency as a measure of afferent visual conduction.

Latency to initiate a saccadic eye movement to a visual target, and visual evoked potential, were measured in seven patients with resolved unilateral optic neuritis. Saccades were delayed when the target was presented to the clinically involved eye, but were normal when the contralateral eye was tested. With binocular target presentation, saccades were symmetric between eyes and normal in latency. In two patients with pituitary adenoma and low-grade bitemporal field defects, saccades were delayed when targets were presented in the temporal field, but were within normal limits when presented in the nasal field. These results cannot be attributed to lesions in the motor pathways. It is concluded that saccadic latency to visual targets is a valid measure of afferent conduction. If the robust delays found in this study prove to have test-retest reliability, saccadic latency may provide a measure of afferent function which is sensitive to the demyelination that preceeds neuronal degeneration and sensitivity loss in patients suspected of having optic neuropathy.

Adenoma