Rapid visual field constriction in a patient with retinitis pigmentosa and pituitary adenoma

Purpose To examine long-term data on optic disc drusen (ODD) from an outpatient hospital series that indicated more cases with advanced visual field constriction than is apparent from other clinical reports. The underlying pathophysiology is discussed, also with regard to enlarged blind spot, which, in view of the small disc at risk, may seem a paradox. Methods This is an observational retrospective study on an eye clinic series (n = 49), focusing on visual acuity, kinetic/static perimetry, and longitudinal trends, to include the question of eventual visual incapacity. Results Forty-nine patients (32 female and 17 male; bilateral ODD in 45) aged 5-76 years (median age 29 years for both sexes) were included in the study. Observation time was 1-54 years, with serial data recorded over at least 3 years in 25 patients. Visual field defects were found in 32 patients, with ODD considered responsible for the visual field defects demonstrated. Advanced unilateral concentric constriction (for the largest Goldmann object) was recorded in 10 patients, and bilaterally in 2. With regard to nonexplanatory side diagnoses, 2 patients had pituitary adenoma, 1 had a cavernous sinus meningioma, and 1 had neurosurgery for an arachnoid cyst. Conclusions We found more cases of marked visual field constriction than reported in other clinical series. A few such cases appeared acute and vascular, but the main trend was clinically quiet over time. All 49 patients could manage visually in daily life.

Download Full-text

Effect of Visual Field Constriction on Visual Search in Orderly Array and Random Array Cancellation Tasks

Psychology ◽

10.4236/psych.2015.614184 ◽

2015 ◽

Vol 06 (14) ◽

pp. 1873-1878 ◽

Cited By ~ 1

Author(s):

Ryotaro Saito ◽

Yoshifumi Ikeda ◽

Hideyuki Okuzumi ◽

Iwao Kobayashi ◽

Mitsuru Kokubun

Keyword(s):

Visual Search ◽

Visual Field ◽

Random Array ◽

Visual Field Constriction

Download Full-text

A novel mutation in the PRPH2 gene in a Chinese pedigree with retinitis pigmentosa and angle-closure glaucoma

BMC Ophthalmology ◽

10.1186/s12886-021-02064-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei-ning Li ◽

Xiu-juan Du ◽

Yu-ting Zhang ◽

Le-yi Wang ◽

Jing Zhu

Keyword(s):

Visual Field ◽

Retinitis Pigmentosa ◽

Novel Mutation ◽

Genetic Mutation ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

The Novel ◽

Progressive Loss ◽

Whole Exome ◽

Transversion Mutation

Abstract Background Retinitis pigmentosa (RP) is a rare, progressive, and hereditary disorder that leads to the progressive loss of vision and visual field, and in some cases blindness. The specific relationship between RP and glaucoma has been debated for decades. Methods In this study, we examined a Han RP family with concomitant angle-closure glaucoma (ACG), performed an inductive analysis of their clinical features and assistant results, and applied whole-exome sequencing (WES) technology for a molecular diagnosis. Results A novel transversion mutation (c.626 T > A) was identified in the peripherin-2 (PRPH2) gene in the proband, resulting in the substitution of Valine to aspartic acid in codon 209. A full ophthalmic examination showed that the proband with the c.626 T > A mutation had a typical RP manifestation, with close angles; however, the proband’s elder brother, who lacked the novel mutation, had a normal fundus and open angles. Conclusion Our results extend the genetic mutation spectrum of PRPH2 in RP, and provide evidence to support a genetic correlation between RP and ACG.

Download Full-text

Left-right and upper-lower light sensitivity asymmetry in visual field defects caused by pituitary adenoma: a retrospective observational study

10.21203/rs.2.9467/v1 ◽

2019 ◽

Author(s):

Yumi Kotoda ◽

Masakazu Kotoda ◽

Masakazu Ogiwara ◽

Hiroyuki Kinouchi ◽

Hiroyuki Iijima

Keyword(s):

Pituitary Adenoma ◽

Visual Field ◽

Light Sensitivity ◽

Visual Field Defects ◽

Lower Visual Field ◽

Lower Quadrant ◽

Lower Light ◽

Left And Right ◽

Left Right Asymmetry ◽

Field Defects

Abstract Background While bitemporal visual field defects are characteristic in pituitary adenoma cases, it is rare to have complete bitemporal hemianopsia that is symmetrical in both eyes and has absolute scotoma throughout both temporal hemifields. Although several researches have investigated asymmetric visual field defects in patients with pituitary adenoma, no precise investigation with statistical analysis regarding the inter-eye and intra-eye symmetry of visual field defects has yet been reported. In this study, we conducted quantitative analysis to explore the asymmetric properties of visual field defects in pituitary adenoma patients. Methods Preoperative Humphrey 30-2 perimetry results were reviewed retrospectively using the charts of 28 pituitary adenoma patients who underwent surgery. Inter-eye light sensitivity comparisons of the temporal and nasal hemifields between the left and right eyes were conducted in each patient to study left-right asymmetry. Upper-lower asymmetry was investigated by comparing the frequency of severe scotoma (light sensitivity 5 dB or less) in the upper and lower visual field quadrants in the temporal and nasal hemifields. Results Left-right asymmetry was demonstrated in 61% of cases in the temporal hemifield and in 57% of cases in the nasal hemifield. Severe scotoma test points were investigated in the worse eye of each patient and were more frequent in the superotemporal quadrant of the visual field compared with the inferotemporal quadrant (P = 0.00029) and in the inferonasal quadrant compared to the superonasal quadrant (P = 0.00268). Conclusions Asymmetric visual field defects between left and right eyes are common in patients with pituitary adenoma. Severe scotoma is more frequent in the upper quadrant of the temporal hemifield and in the lower quadrant of the nasal hemifield.

Download Full-text

Factors Influencing Visual Field Recovery after Transsphenoidal Resection of a Pituitary Adenoma

Korean Journal of Ophthalmology ◽

10.3341/kjo.2017.0094 ◽

2018 ◽

Vol 32 (6) ◽

pp. 488 ◽

Cited By ~ 1

Author(s):

Dong Kyu Lee ◽

Mi Sun Sung ◽

Sang Woo Park

Keyword(s):

Pituitary Adenoma ◽

Visual Field ◽

Factors Influencing ◽

Transsphenoidal Resection

Download Full-text

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

Neurosurgery ◽

10.1093/neuros/nyaa318 ◽

2020 ◽

Vol 88 (1) ◽

pp. 106-112 ◽

Cited By ~ 1

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 (>5%) and thin (<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.

Download Full-text