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S Trauzettel-Klosinski

Publications and source records attributed to S Trauzettel-Klosinski.

At least 19 recordsLinked to original sources
PubMed2006

Effect of visual restitution training on absolute homonymous scotomas.

The authors examined 16 patients with stable homonymous visual field defects (HVFDs) with static automated perimetry (SAP). Training effect E was defined as difference of the proportions of absolutely defective locations in all test locations, before and after visual restitution training (VRT). E was 0.05 +/- 0.05 (mean +/- SD). The authors observed a relevant training effect (E >or= 0.12) in two subjects, but only monocularly. VRT has little effect on absolute HVFDs in SAP.

Adult↗
PubMed2006

New standardised texts for assessing reading performance in four European languages.

AIMS: To develop standardised texts for assessing reading speed during repeated measurements and across languages for normal subjects and low vision patients. METHODS: 10 texts were designed by linguistic experts in English, Finnish, French, and German. The texts were at the level of a sixth grade reading material (reading ages 10-12 years) and were matched for length (830 (plus or minus 2) characters) and syntactic complexity, according to the syntactic prediction locality theory of Gibson. 100 normally sighted native speaking volunteers aged 18-35 years (25 per language) read each text aloud in randomised order. The newly designed text battery was then applied to test the reading performance of 100 normally sighted native speaking volunteers aged 60-85 years (25 per language). RESULTS: Reading speed was not significantly different with at least seven texts in all four languages. The maximum reading speed difference between texts, in the same language was 6.8% (Finnish). Average reading speeds (SD) in characters per minute are, for the young observer group: English 1234 (147), Finnish 1263 (142), French 1214 (152), German 1126 (105). The group of older readers showed statistically significant lower average reading speeds: English 951 (97), Finnish 1014 (179), French 1131 (160), German 934 (117). CONCLUSION: The authors have developed a set of standardised, homogeneous, and comparable texts in four European languages (English, Finnish, French, German). These texts will be a valuable tool for measuring reading speed in international studies in the field of reading and low vision research.

Adolescent↗
PubMed2005

Does visual restitution training change absolute homonymous visual field defects? A fundus controlled study.

AIM: To examine whether visual restitution training (VRT) is able to change absolute homonymous field defect, assessed with fundus controlled microperimetry, in patients with hemianopia. METHODS: 17 patients with stable homonymous visual field defects before and after a 6 month VRT period were investigated with a specialised microperimetric method using a scanning laser ophthalmoscope (SLO). Fixation was controlled by SLO fundus monitoring. The size of the field defect was quantified by calculating the ratio of the number of absolute defects and the number of test points; the training effect E was defined as the difference between these two ratios before and after training. A shift of the entire vertical visual field border by 1 degrees would result in an E value of 0.14. RESULTS: The mean training effect of all right eyes was E = 0.025 (SD 0.052) and all left eyes E = 0.008 (SD 0.034). In one eye, a slight non-homonymous improvement along the horizontal meridian occurred. CONCLUSIONS: In one patient, a slight improvement along the horizontal meridian was found in one eye. In none of the patients was an explicit homonymous change of the absolute field defect border observed after training.

Adult↗
PubMed2000

The importance of sustained attention for patients with maculopathies.

Sustained attention enhances perception in eccentric positions in the visual field, which helps patients with foveal vision loss to develop a peripheral 'preferred retinal locus' (PRL). Besides central scotoma topography, local variations of attentional performance could influence the choice of PRL location. We tested sustained attention augmenting peripheral letter recognition in 23 maculopathy patients and 15 normally-sighted subjects (eight positions, 8 degrees eccentricity). Performance was shown to depend on tested location, which was the same in patients and normals. This indicates that the choice of the PRL location after foveal vision loss can be influenced by topographic features of sustained attention.

Adolescent↗
PubMed2000

[Reading ability and need for reading aids, inadequate management of a nursing home population].

INTRODUCTION: In our society people are getting older and often become handicapped and immobile. Reading then is one of their main passtime and very important for their social integration and independence. PATIENTS AND METHODS: Seventy-seven (6 males, 71 females) randomly chosen elderly people (age ranged from 77 to 94 years, mean: 85.5 years) staying in nursing homes were examined concerning their reading ability of newspaper print with their own reading equipment. Exclusion criteria were extensive organic diseases and impaired mental ability, such as dementia. Relevant anamnestic data, including ophthalmologic, family and social history were ascertained by questionnaire. Special attention was given to visual acuity for near distance, reading ability, motivation and personal reading aids. Further questions dealt with general diseases, medication, social contacts inside and outside the nursing homes and the former occupation of the patient. If reading of newspaper print with individual glasses was impossible, the effect of magnification was evaluated and the magnification factor was determined (Zeiss reading charts). RESULTS: Thirty-eight people (45%) were unable to read with their own reading glasses. 91% of them regained reading ability by magnification, they had inadequate visual aids. 77% of this group had a magnification requirement of 1 to 3 times, 14% needed 10 to 25 times of magnification and 9% more than 25 times. Only one person had an electronic magnifying reading system (CCTV). CONCLUSION: Reading aids of elderly people very frequently are insufficient. Magnification can be helpful in most cases and various magnification systems are available. With this support elderly people could regain their quality of life, their independence and socialization. Nursing costs could also be reduced.

Aged↗
PubMed1999

Evaluation of the Night Vision Spectacles on patients with impaired night vision.

BACKGROUND: The Night Vision Spectacles (NiViS) were developed by a consortium of European companies to assist individuals who suffer from impaired night vision. They consist of a head-mounted video camera (input) and binocular displays (output) connected to a portable computer processor, which uses an algorithm to enhance the luminance and contrast of the video image. METHODS: Eighteen patients with impaired night vision were tested, including those with retinitis pigmentosa (7), Usher syndrome (2), fundus albipunctatus (1) and complete (4) and incomplete (4) congenital stationary night blindness. Normal trichromats (3) and typical, complete achromats (2) acted as controls. A battery of tests assessed: visual acuity at 5 m (projection unit) and 1 m (chart) and at high and low contrasts; contrast sensitivity; absolute and increment threshold; the influence of glare; contrast motion detection; and hand-eye performance. The tests were performed, with and without the NiViS, at three adaptation levels: low scotopic (10(-3) cd/m2), high scotopic (10(-2) cd/m2) and mesopic (10(-1) cd/m2). RESULTS: At the low and high scotopic levels, the majority of patients showed improved performance on the visual acuity, contrast sensitivity and motion contrast tests with the NiViS. At the mesopic level, the advantage with the NiViS was greatly reduced, but still present for contrast sensitivity. CONCLUSION: Patients with impaired night vision can benefit from the NiViS when performing tasks involving contrast and motion perception. Those with normal visual fields and retaining good photopic vision will benefit more than those with constricted visual fields and impaired cone vision. Recommendations regarding desirable improvements of the NiViS and suitability for the individual patient are given.

Adolescent↗
PubMed1998

Eye movements in reading with hemianopic field defects: the significance of clinical parameters.

BACKGROUND: Reading disability is the main problem in patients with hemianopic field defects (HFD). The purpose of this study was to examine eye movement patterns in HFD with special emphasis on the importance of clinical parameters. METHODS: 40 patients with HFD (21 left, 19 right) and 21 normal subjects were examined by an infrared reflection system to record eye movements during reading and by Tübingen perimetry. Reading and clinical parameters were correlated. RESULTS: Reading speed was reduced in all patients compared to normal subjects (853 vs 1541 characters/min), in right (785 char/min) more than in left HFD (915 char/ min). The number of saccades and regressions per line was markedly increased in right HFD (9.8 vs 4.5; 2.2 vs 0.3), less so in left HFD (6.4; 1.0). The number of saccades during the return sweep was more increased in left HFD (1.5 vs 0.5) than in right HFD (0.9). Reading parameters improve with increasing distance of HFD to the visual field center (minimum in right HFD 5 degrees, in left HFD 2 degrees) and with increasing time since onset. Some left HFD patients learn a predictive strategy for the return sweep. The effect is less pronounced for age and skill and is absent for the localization of the lesion. CONCLUSION: Patients with right HFD are more disabled. The side of the HFD, its distance to the visual field center and the time since onset are significant parameters for reading performance. The analysis of reading parameters in correlation with clinical parameters provides valuable information about the necessary perceptual field and learning effects and is helpful in rehabilitation.

Adult↗
PubMed1998

The vertical field border in hemianopia and its significance for fixation and reading.

PURPOSE: The existence of macular sparing, a central seeing area of several degrees within the hemianopic field defect, has been controversial for a long time, because inaccurate fixation during perimetry can produce ambiguous results. The visual field border in hemianopia was studied to examine whether a vertical strip of hemifield overlap described in monkeys exists in humans and whether additional macular sparing could be found. METHODS: Vertical triplets of dots were scanned on the retinas of eight patients (13 eyes) with hemianopia at different eccentricity from the vertical meridian during strict simultaneous fixation control using a scanning laser ophthalmoscope (SLO). Additionally, eye movements were measured by SLO and by an infrared reflection system while subjects read texts. RESULTS: Macular sparing of 2 degrees to 5 degrees and absence of sparing were observed. The presence and amount of sparing influenced fixation behavior, reading performance, and reliability of conventional perimetry. The smaller the macular sparing, the less stable the fixation. In the absence of sparing, either central unstable fixation with frequent saccades toward the hemianopic side or eccentric fixation occurred, resulting in a shift of the field defect toward the hemianopic side. A vertical strip of sometimes partial perception was found in 12 eyes at 0.5 degrees from the midline. CONCLUSIONS: Macular sparing and a slight vertical strip of hemifield overlap exists in humans. Adaptive strategies like eccentric fixation and predictive saccades improve reading performance and can augment rehabilitation.

Adult↗
PubMed1997

[Examination strategies in simulation and functional vision disorders].

The diagnosis of malingering and functional visual loss should be proven by specific tests-after the exclusion of differential diagnoses such as optical disturbances, amblyopia, early stages of macula and optic nerve disease and cortical lesions. Malingering and functional visual loss are based on different causes and pathogenetic mechanisms. However, they produce the same symptoms and can therefore be examined by the same methods. The strategy consists of three parts: 1) check the reproducibility of the results, 2) specific procedures: provocation of reflectory responses, deception, measurement of the same function with different methods and objective methods and 3) proof. In alleged bilateral blindness the provocation of reflexes and deceptive strategies are especially useful, in alleged bilateral reduction of visual acuity deceptive methods (related to the size of the optotype), the examination of central vision by other methods (equivalents to visual acuity) and objective methods are applied. In alleged monolateral blindness or reduction of visual acuity the binocular tests are valuable. Additionally, methods to provoke reflexes, especially pupil reaction, are used as well as the measure of equivalents to visual acuity. In alleged concentric constriction of the visual fields three strategies are mainly used: 1) check if visual field size is in accordance with the visual angle, 2) different methods to examine the isopters and 3) different perimetric methods. In case of an alleged hemianopic field defect the following methods are of special value: 1) binocular examination, 2) reading ability, 3) different perimetric methods and 4) half-field stimulation. After finishing the specific tests the diagnosis of malingering or functional visual loss should be unambiguous and the existing function should be determined. Strategies for further management are shown--dependent on the pathogenesis: the aim is to avoid repetition and to set the right course for the future. In case of malingering the reliable expert's report is helpful. In case of functional visual loss it is important to avoid unnecessary examinations and to offer specific aids.

Blindness↗
PubMed1992

Horner's syndrome: a retrospective analysis of 90 cases and recommendations for clinical handling.

The records of 90 cases of oculosympathetic paresis (1982-1991), 39 women and 51 men aged between 3 months and 82 years, were evaluated. The mean baseline anisocoria was 0.92 mm but did not exceed 2.4 mm. The mean difference in the position of the upper eyelid was 2.3 mm. Enophthalmus of 1 mm or more was found in only 25% and exophthalmus of 1 mm or more, in 18%. Exophthalmus or enophthalmus of more than 2 mm was not encountered. The cocaine test (5% solution in most cases) was performed in 85 cases and could be quantified in 65 cases. The average dilation of the involved pupil was 0.52 mm, whereas the normal pupil dilated 2.14 mm. The average postcocaine anisocoria was 2.54 mm. Hydroxyamphetamine 1% dilated the involved pupil in cases with presumed preganglionic lesions slightly more than the normal fellow pupil (2.39 mm and 2.09 mm respectively). The difference was significant (P < 0.05). In postganglionic lesions, the hydroxyamphetamine dilation was 0.57 mm. The hydroxyamphetamine test had a specificity of 90% for postganglionic lesions and 88% for preganglionic. An underlying acquired disease could be identified in 53 cases; 6 cases were congenital. In 37 cases (including the congenital ones), no cause was found. Among the 33 preganglionic lesions, only one malignant tumor was found, whereas 6 malignant tumors were encountered among the 20 postganglionic cases. Additional ocular motor palsies or other local signs were present in these 6 cases. Goiter was frequently associated with preganglionic Horner's syndrome.

Adolescent↗
PubMed1992

The Aulhorn flicker test: possibilities and limits. Its use in optic neuritis for diagnosis, differential diagnosis, monitoring the course of the disease, and assessing the effect of oral prednisolone.

The Aulhorn flicker test, which measures subjective brightness in relation to flicker frequency, is of high specificity (98%) and sensitivity (85.5%) in active optic neuritis (ON). The test has proved to be valuable in the diagnosis and differential diagnosis of ON and in monitoring the course of the disease. The first part of this paper gives an overview based on more than 10 years of experience and on the evaluation of more than 1000 eyes, 250 of them with active ON. The possibilities and limits of the test are analyzed. The second part of the paper presents new results of a prospective, randomized, and controlled treatment study. The Aulhorn flicker test was used to determine whether a prednisolone effect would be assessable by means of this subtle parameter. A total of 50 patients were treated orally with either methylprednisolone (100 mg/day initially) or vitamin B1 (100 mg/day), 38 of them in a double-blind fashion. Although a trend toward faster recovery in favor of prednisolone treatment was noted, no long-term benefit was observed after 1 year.

Administration, Oral↗
PubMed1991

[Effect of prednisolone on the course of optic neuritis. Results of a double-blind study].

The treatment of optic neuritis (ON) with corticosteroids has been controversial for many years. None of the previous studies with the usual dosage of steroids or ACTH has proven that this therapy is beneficial. However, these studies did not apply sensitive parameters for assessing the course of ON. The aim of this study was to examine the effect of corticosteroids using subtle parameters. The study design emphasized: 1. strict criteria for patient selection; 2. frequent controls during the initial period of the disease, follow-up for 1 year; 3. double-blind conditions with randomized groups; 4. assessment of the course with sensitive parameters, including visual acuity, visual evoked potentials (VEP) and the Tübingen Flikker Test, also called the Aulhorn Flicker Test, which monitors the activity of the ON. These last two tests were used for the first time in a controlled treatment study in ON. Thirty-eight patients with acute ON were treated orally in a double-blind procedure with either methylprednisolone (initially 100 mg daily, reduction every 3 days) or with vitamin B1 (100 mg thiamin daily) in the control group. The results of the Flicker Test and VEP showed a trend toward faster recovery under prednisolone within the first few weeks after onset of the disease. After 1 year none of the parameters examined showed any difference between the two groups. Thus, although prednisolone treatment in the dosage mentioned above seems to speed up recovery in the initial phase in some patients, no long-term benefit could be demonstrated.

Adult↗
PubMed1990

[Comparison of the Aulhorn flicker test with visual evoked potentials in the diagnosis of optic neuritis].

The Aulhorn flicker test and visual evoked cortical potentials (VEP) are of great value for the diagnosis of optic neuritis (ON). In the present study, the two methods were compared for the first time within the same group of patients. The study comprised 405 eyes (175 suffering from active or subsided ON). The results were evaluated with a double-blind procedure. With the flicker test, the subjective brightness of flickering light is determined as a function of the flicker frequency. This test gives pathological results only in active ON and normalizes when the active phase is over. The test can discriminate between active and subsided ON as well as between the recurrent and chronic courses of the disease. Differentiation is not possible with the VEP, since the VEP latencies are prolonged even after the end of the active period of the disease. The sensitivity of the flicker test was 84.4%. The sensitivity of the VEP was 72.7% for our group of patients suffering from ON if the criterion of increased latency was used alone. In the diagnosis of multiple sclerosis (MS), the proportion of correctly identified pathological VEP results is increased because of the detection of demyelination of the optic nerve that causes no clinical symptoms. The specificity of the flicker test was 97.8% and that of the VEP 86.5%. If both methods were combined, the sensitivity was 98.4% and specificity 99.6%. The two methods obviously have different characteristics and seem to rely upon different demyelination effects. Each method has its advantages and disadvantages as well as optimal indications.(ABSTRACT TRUNCATED AT 250 WORDS)

Evoked Potentials, Visual↗
PubMed1989

Various stages of optic neuritis assessed by subjective brightness of flicker.

In the Aulhorn flicker test, the subjective brightness of a steady field is matched to that of a flickering field at 50 to 0 Hz. The test gives pathologic values only for active optic neuritis (ON) and gives normal results for normal eyes and eyes with subsided ON and other diagnoses, with a specificity of 98% and a sensitivity of 85.5%. Characteristic variations of the curves of subjective brightness during the course of ON allow a subtle assessment of five different disease stages, and there is a clear distinction between various disease patterns, ie, acute, chronic, recurrent, diminishing, and subsided ON. This distinction is impossible on the basis of visual evoked potentials. The test can be done easily and quickly without major technical equipment, even in an ophthalmologist's office.

Flicker Fusion↗
PubMed1989

Standardization of the Tübingen flicker test.

In the Tübingen flicker test, the subjective brightness of a steady field is adjusted to that of a flickering test field at 50-0 Hz. This test has proven itself as a valuable and highly specific method in the diagnosis of optic neuritis (ON). This paper reports on the development of new judgement criteria and their standardization, based on a new cohort of 527 eyes, 138 of them with florid ON. After improving the conditions of examination and evaluation the optimal criteria for the definition of a pathological result were determined in an explorative manner that is described in detail. The criteria finally chosen are defined such that they preserve the high specificity (98%) of the test, while also retaining a high sensitivity (85.5%).

Flicker Fusion↗
PubMed1989

[Periphlebitis retinae ("Rucker")--a symptom of disseminated encephalomyelitis].

Within a group of neuro-ophthalmic patients (147 patients with either florid or cured optic neuritis (ON), five (3.4%) were found to be suffering from retinal periphlebitis "Rucker". Of these five patients, three were also suffering from Encephalomyelitis disseminata (E.d.). One patient had ON without E.d.; in another there were sufficient grounds for a tentative diagnosis of ON during the follow-up period. The relatively low percentage of patients with retinal periphlebitis associated with a basic demyelinating condition can be attributed primarily to the fact that the group of patients examined consisted of neuro-ophthalmic patients in most of whom the basic disease manifested itself for the first time. The multi-focal processes involved in demyelinating diseases become apparent through inflammatory focuses with varying degrees of activity, often in the same eye.

Adult↗