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PubMed2001

Unusual spontaneous and training induced visual field recovery in a patient with a gunshot lesion.

Over a period of more than 3 years, changes in visual and neuropsychological functions were examined in a patient with a visual field defect caused by a cerebral gunshot lesion. Initially, the patient had been completely blind, but after 6 months of spontaneous recovery, he showed a homonymous bilateral lower quadrantanopia and impairment of higher visual functions. Unexpectedly, recovery still continued after the first 6 months. This process was documented in detail by visual field examinations using high resolution perimetry. When visual field size had stabilised almost 16 months after the lesion, further improvement could be achieved by visual restitution training. The duration and extent of spontaneous recovery were unusual. In spontaneous as well as in training induced recovery, progress was mainly seen in partially defective areas (areas of residual vision) along the visual field border. Thus, it is speculated that modulation of perceptual thresholds in transition zones of visual field defects contributes to spontaneous and training induced recovery.

Adult↗
PubMed1997

Repeatable diffuse visual field loss in open-angle glaucoma.

PURPOSE: The authors determined the frequency of repeatable diffuse loss as the only form of visual field damage in patients with early to moderate open-angle glaucoma in a prospective follow-up study. METHODS: The study contained 113 patients (median age, 64 years; range, 17-89 years) who were tested at 6-month intervals with program 30-2 of the Humphrey Field Analyzer (Humphrey Instruments Inc., San Leandro, CA). Although the inclusion criterion for visual acuity was > or = 20/40, on entry, 94 (83.2%) patients had an acuity of > or = 20/25. Cumulative defect curves were generated for all visual fields (median per patient, 7; range, 4-9). After randomizing the order and removing all patient information, two observers independently rated each visual field as being "normal" or showing "diffuse," "localized," or "diffuse and localized" loss. We defined repeatable diffuse loss as occurring when at least two thirds of the number of fields in the follow-up were classified as "diffuse." RESULTS: Fourteen patients (12.4%) had repeatable diffuse loss according to the cumulative defect curves. After reviewing their clinical charts, we excluded six of these patients because of early lens changes despite good visual acuity and three because of a suggestion of localized loss (on pattern deviation probability plots) in addition to the predominantly diffuse loss. The remaining five (4.4%) patients had repeatable diffuse loss that was due solely to open-angle glaucoma. CONCLUSION: Although diffuse visual field loss is exaggerated by factors other than glaucoma in the majority of patients, it can occur repeatedly in a small number of patients as the only sign of visual field damage.

Adolescent↗
PubMed1992

Visual acuity and visual field development after cryocoagulation in infants with retinopathy of prematurity.

Visual development was studied in 10 very-low-birth-weight infants (less than 1500 g) with retinopathy of prematurity (ROP) stage 3+ who had been treated with cryocoagulation in both eyes. Binocular visual acuity (acuity cards method) and binocular visual fields (kinetic perimetry) were assessed repeatedly in the first year of life. At 12 months corrected age, visual acuity was normal in seven and impaired in three infants, who appeared to be severely myopic. Normal visual fields were found in eight infants at this age. The results indicate that cryotherapy in cases of ROP stage 3+ does not interfere with visual acuity development. The effect on visual field development needs further investigation.

Cryosurgery↗
PubMedDate not supplied

Higher order aberrations across the horizontal visual field.

The relationship between higher order aberrations and position in the horizontal visual field is investigated in normal and refractive corneal surgery subjects. Individual aberration coefficients are obtained from two studies using five untreated subjects and two myopic subjects following conventional laser assisted in situ keratomileusis (LASIK) surgery. Measurements are made out to 40 deg in the temporal and nasal visual fields. For the untreated subjects, horizontal coma is linearly influenced by position, and spherical aberration and secondary astigmatism are influenced quadratically by position (45 subjects). For the myopic LASIK subjects, the horizontal coma is opposite in sign from that for unoperated eyes at similar visual field positions, and this can be attributable largely to anterior corneal asphericity. Again, both spherical aberration and secondary astigmatism are influenced quadratically by position. To summarize, horizontal coma, spherical aberration, and secondary astigmatism change systemically across the horizontal visual field, and corneal asphericity has a major influence on the rate of change of coma and its sign.

Cornea↗
PubMed1997

Effect of size and frame of visual field on the accuracy of an aiming movement.

The aim of this study was to analyse the effects of manipulating the size and contour of the visual field on the accuracy of an aiming task. Subjects were required to perform pointing movements without seeing their moving hand. The target was displayed in either a wide structured visual field (control condition), a narrow visual field with orthogonal frame, or a narrow visual field with circular frame. The visual information surrounding the target was always provided prior to movement onset, but during the execution of the movement on only half of the trials. Overall, the results showed that undershooting was a common performance characteristic in all of the conditions. In comparison to the control performance, an increase of the degree of undershoot was found when the target was displayed inside a narrower visual field. An additional radial error was found when the contour of the visual scene was circular, but only when the visual context was available during the movement. The same pattern of results was observed for variable error. However, angular errors were not found to vary over the different conditions. Overall, the findings suggested that the visual context contributed to the assessment of the target locations, and the subsequent motor programming. Furthermore, visual information aided the on-line control of the unseen hand, but the extent of this was dependent on the size and shape of the frame denoting the visual scene. Finally, in the absence of any unexpected perturbation, the en-route amendment of the arm trajectory, based on visual information processing, seemed to be more related to distance than azimuth control.

Adult↗
PubMed1977

Visual field changes in ocular hypertension. A computer-based analysis.

A minicomputer system has been developed to digitize and store visual field data. In 110 cortiocosteroid-nonresponding subjects aged 10 to 75, the area of the i4e and i2e isopters and of the blind spot changed linearly as a function of age. Within this population the same visual field parameters were randomly distributed with respect to intraocular pressure. In 32 cortiocosteroid responders (increase in intraocular pressure to over 31 mm Hg after topical administration of corticosteroids) with normal visual fields, the central visual field area (i2e isopter) was reduced as a nonlinear function of IOP. Increases in IOP in excess of 8 mm Hg were required to produce significant mean reductions in central visual field area.

Adolescent↗
PubMed1993

Analytical and statistical survey of early stages of open-angle glaucoma with low luminance visual field.

The purpose of this study was to show the early visual field signs in glaucoma using the 'Moniteur Ophtalmologique' at a background mesopic luminance of 0.3 apostilbs. Forty-five patients were selected, and 68 eyes with suspected early glaucoma were examined. Among the defects which were studied, we noticed a predominance of what we called pericaecal scotoma (PCS) and levelling. These two first signs appear as an alarm signal. To detect the early visual field signs of open-angle glaucoma developing, this study recommends the use of a background mesopic luminance of 0.3 apostilbs and observation for two uncommon visual field signs: PCS in evolution around the blind spot and a slight decrease in central mesopic sensitivity called levelling.

Adult↗
PubMed1990

Development of visual field advantage for digit and random shape recognition: comparison of cross-sectional and longitudinal studies.

The visual field advantage for digits and random shapes recognition was investigated using both longitudinal and cross-sectional methods with children from ages from 4 to 6. A right visual field advantage for digit recognition and left visual field advantage for random shape recognition were found in the age 4 group. There was no evidence of developmental increase in visual field advantage with age, though there was slight gender difference in the development of visual field advantage. Comparisons of the results of longitudinal and cross-sectional methods revealed negligible differences.

Attention↗
PubMed1992

Effect of timolol versus pilocarpine on visual field progression in patients with primary open-angle glaucoma.

BACKGROUND: Relatively few studies have been conducted linking decreasing intraocular pressure (IOP) to preservation of visual field. This investigation was conducted to determine if this link could be made and to compare the long-term effect of two ocular hypotensive agents on preservation of visual field. METHODS: In an observer-masked study, 189 patients with primary open-angle glaucoma received either timolol or pilocarpine by random allocation. The dose of antiglaucoma agent was increased from 0.25% to 0.5% twice daily for timolol or from 2% to 4% four times daily for pilocarpine if the initial IOP response was inadequate. After an on-treatment baseline, visual fields were followed every 4 months for 2 years using the Octopus program 32. RESULTS: Compared with timolol, significantly more patients receiving pilocarpine discontinued use because of inadequate IOP control (P < or = 0.01). By comparing the mean visual field scores, it can be seen that the pilocarpine group had a significantly worse score at all timepoints from month 4 to month 24. The pilocarpine group also had a greater mean number of test loci with decreased sensitivity of 5 or more decibels (dB) at all timepoints. The mean within-patient regression slope for timolol was 0.01 dB/month and for pilocarpine was -0.06 dB/month (P < 0.01). The study has shown that over a 2-year period, patients treated with pilocarpine 2% or 4% four times daily experienced a significantly greater visual field deterioration than that seen in patients receiving either 0.25% or 0.5% timolol twice daily. CONCLUSION: Although these data do not support a link between lowering of IOP and visual field preservation, treatment with timolol was associated with significantly less visual field loss than treatment with pilocarpine.

Double-Blind Method↗
PubMed1987

Patterns of early visual field loss in open-angle glaucoma.

We examined two groups of patients with primary open-angle glaucoma with distinctly different patterns of early visual field loss using two visual field indices: mean defect and loss variance. Patients were selected on the basis of visual field criteria only. Eight patients were selected for diffuse depression of the differential light sensitivity without localized scotomas (mean defect greater than 3.0 decibels, loss variance less than 10.0 decibels). Seven patients were selected for localized scotomas without diffuse depression of the differential light sensitivity (mean defect less than or equal to 3.0 decibels, loss variance greater than or equal to 20.0 decibels). Patients with diffuse depression manifested intraocular pressures that were higher (mean peak pressure +/- S.E.M., 27.6 +/- 1.2 mm Hg) than those with localized defects (22.4 +/- 1.4 mm Hg). The optic disk rim area of the localized loss group (mean +/- S.E.M., 1.02 +/- 0.15 mm2) was significantly smaller (P less than .05) than the disk rim area of the diffuse loss group (1.33 +/- 0.07 mm2). This difference was largely because of thinner temporal disk rims in the localized loss group. Different patterns of visual field loss may be caused by different mechanisms of glaucomatous optic nerve damage.

Aged↗
PubMed2001

Perfusion of the optic nerve head and visual field damage in glaucomatous patients.

PURPOSE: To examine the relation between perfusion of the optic nerve head and visual field defects in glaucomatous patients. METHODS: A study was performed on 94 patients affected with primary open-angle glaucoma. The optic nerve head blood flow was measured by means of a scanning laser Doppler flowmeter (Heidelberg Retina Flowmeter). Blood volume, flow and velocity were analysed in two areas of the rim and in one area of the lamina cribrosa. The visual field was tested with the 30-2 full threshold white-on-white program and mean deviation (MD) and corrected pattern standard deviation (CPSD) were considered as parameters of visual field defects. RESULTS: The interindividual analysis showed that the vascular parameters of the neuroretinal rim circulation were not significantly correlated with visual field parameters. The blood volume, flow and velocity of lamina cribrosa correlated significantly with both MD (R=0.519, R=0.549 and R=0.531, respectively; P<0.001) and CPSD (R=-0.496, R=-0.363 and R=-0.363, respectively; P<0.001). The intraindividual correlations (right-left differences of parameters) showed that the side differences of MD and CPSD correlated significantly with the side differences of blood volume (R=0.511 and R=-0.477, respectively), flow (R=0.554 and R=-0.390, respectively) and velocity (R=0.541 and R=-0.372, respectively) in lamina cribrosa. CONCLUSION: These findings suggest that in glaucoma patients the perfusion parameters of lamina cribrosa are significantly correlated with visual field defects.

Adult↗
PubMed1984

[Unilateral visual field defect due to optic nerve compression by non-sclerotic internal carotid and ophthalmic arteries. A case report].

A case of unilateral visual field defect due to optic nerve compression by non-sclerotic internal carotid and ophthalmic arteries was reported. A 14-year-old boy was admitted to our department because of constricted visual field of the right eye. The right ophthalmic artery originated from more distal portion of the internal carotid artery than usual on angiogram. CT, PEG and other roentgenologic examinations revealed no abnormalities. But the possibility of para-sellar tumor still remained, so the right optic nerve was explored by a right frontotemporal approach. The optic nerve was found to be compressed not by any sort of mass lesion but by the non-sclerotic internal carotid and ophthalmic arteries against the rim of the optic canal. Then a microsurgical unroofing of the optic canal was performed to relieve the nerve from the compression. The decompressed upper surface of the nerve was found to be discolored yellow-white. Unfortunately, no improvement in the visual field was obtained after operation. Visual field defect due to vascular compression of the optic nerve has been discussed in only several reports. There have been only 8 cases of surgically treated unilateral visual field defect due to vascular compression. Most of them were the results of compression by the sclerotic or fusiformly enlarged internal carotid arteries and were found in the patients of middle age. Four cases presented with lower half visual field defects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1999

Transitory and permanent visual field defects induced by occipital lobe seizures.

Visual field defects are rarely associated with epilepsy. We report two patients with a long history of cryptogenetic occipital epilepsy. Both patients suffer complex partial crises accompanied by concentric reduction of the visual field followed, in the first one, by a prolonged left homonymous hemianopsia, and in the second one, by a permanent right inferior quadrantopsia. Occipital and occipito-temporal epileptic activity has been registered between seizures in both patients, and in one patient also during the seizure itself. Differential diagnosis has been considered, especially with migraine.

Adult↗
PubMed2004

Rate of visual field progression in primary open-angle glaucoma and primary angle-closure glaucoma.

To estimate the rate of visual field progression in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), we reviewed the medical records of POAG and PACG patients who had a minimum of 5-year longitudinal Goldmann visual field data. I4e and I2e isopters were quantified using grid systems. The rate of change was calculated from the slope of a linear fit to a series of average visual field scores. Twenty-three eyes of POAG patients and 25 of PACG patients were studied. The rate of visual field score change was -2.00 +/- 2.0% per year in the PACG group, and -0.81 +/- 1.0% per year in the POAG group. In these two patient groups, who were on conventional treatment at two referral hospitals, better visual field on initial presentation yielded faster progression in the POAG group, while the higher average of highest intraocular pressure in each year during follow-up was related to faster progression in the PACG group.

Adult↗
PubMed1997

The influence of a central stimulus on visual field measurements in children from 3.5 to 30 months of age.

PURPOSE: To provide normative data on the effect of a central competing stimulus on monocular visual field extent in 3.5- to 9-month-olds and adults, and binocular visual field extent in 11- to 30-month-olds. METHODS: Visual field extent along diagonal meridia was measured in 180 infants and children (N = 30 at 3.5, 7, 9, 11, 17, and 30 months) and 20 adults, using static perimetry. Stimuli were 3-deg, 10-Hz flickering, yellow light-emitting diodes (LEDs). Each subject was tested with 12 trials in which the central stimulus remained on and 12 trials in which the central stimulus was turned off during presentation of the peripheral stimulus. RESULTS: A competing stimulus produced a decreased frequency of eye movements at 17 months and evidence suggestive of decreased measured field extent at 17 and 30 months. CONCLUSIONS: A continuously present central stimulus does not produce underestimation of visual field extent in 3.5- to 9-month-old infants with normal vision and adults tested monocularly and 11-month-old infants tested binocularly. However, visual field extent may be underestimated in 1- and 2-year-olds if a competing central stimulus is used.

Adult↗
PubMed1995

Abnormal ipsilateral visual field representation in areas 17 and 18 of hypopigmented cats.

We compared the central projections of retinal ganglion cells in temporal retina and the cortical representation of visual fields in areas 17 and 18 in cats with various hypopigmentation phenotypes (albino, heterozygous albino, Siamese, and heterozygous Siamese). In all cats studied, we found that the extent of abnormal ipsilateral visual field representation varied widely, and more of the ipsilateral visual field was represented in area 18 than in area 17. The greatest degree of ipsilateral visual field representation was found in albino cats, followed by Siamese, heterozygous albino and heterozygote Siamese cats, respectively. Additionally, in the different groups there was wide variation in the numbers of contralaterally projecting alpha and beta ganglion cells in temporal retina. In all cases, however, contralaterally projecting alpha cells were found to extend further into temporal retina than beta cells. We found that in each cat studied, the maximum extent of the abnormal ipsilateral visual field representation in areas 18 and 17 corresponded to the location of the 50% decussation line (i.e., the point where 50% of the ganglion cells in temporal retina project to the contralateral hemisphere) for alpha and beta cells, respectively, for that cat. Our results suggest that the extent of the abnormal visual field representations in visual cortex of hypopigmented cats reflects the extent of contralaterally projecting retinal ganglion cells in temporal retina.

Albinism↗
PubMed1988

A computer-assisted instruction course to teach visual-field interpretation.

A computer-assisted instruction course for visual-field interpretation is described. A multiple-choice, question-and-answer drill was constructed using the VAX/VMS minicomputer and commercially available educational software. Medical and paramedical personnel can use this course to further their knowledge of visual-field description, the location of lesions which lead to visual-field defects, and the underlying processes that cause some of these defects. The advantages of using a particular computer terminal because of its graphic capabilities and screen layout are described. Other uses of computer-assisted instruction in ophthalmology are discussed and encouraged.

Computer-Assisted Instruction↗