Junctional Scotoma and Patterns of Visual Field Defects Produced by Lesions Involving the Optic Chiasm

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Laura C. Donaldson ◽  
Arshia Eshtiaghi ◽  
Simone Sacco ◽  
Jonathan A. Micieli ◽  
Edward A. Margolin
2011 ◽  
pp. 43-47
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak ◽  
Robert B. Daroff

Dysfunction of the optic chiasm typically produces bitemporal visual field defects. Chiasmal dysfunction most frequently results from compression by extrinsic lesions, such as pituitary macroadenomas and suprasellar meningiomas. We describe the clinical signs of chiasmal dysfunction in this chapter. We also discuss the evaluation and management of pituitary apoplexy.


2019 ◽  
pp. 61-66
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak

Dysfunction of the optic chiasm typically produces bitemporal hemianopic visual field defects. Optic chiasmal dysfunction most often results from compression by extrinsic lesions, such as pituitary macroadenomas and meningiomas. In this chapter, we begin by describing the various bitemporal hemianopic visual field defects that can occur with optic chiasmal dysfunction. We next list potential causes of optic chiasmal dysfunction. We then review the clinical features and evaluation of pituitary apoplexy, which results from infarction of (or hemorrhage into) a pituitary macroadenoma. Lastly, we discuss the management of pituitary apoplexy, including the indications for and timing of surgical decompression, and review factors that affect the prognosis for visual recovery.


Author(s):  
Jonathan D. Wirtschafter ◽  
Thomas J. Walsh

The purpose of any medical test is to confirm or rule out a diagnosis based on the clinical facts. In performing perimetry, the printout of the defect is not the end of the test. For even the most experienced reader, the test results at best tell the location of the defect. The next step is to consider the causes of such a defect in that part of the vision system. The experienced perimetrist will look at the results and suggest a differential list of causes. The primary diagnostic list is frequently aided by adding to the perimetry the medical history and other physical signs. The results of both then lead to the next step: ordering tests to confirm the cause of the field defect. It may require the ordering of a magnetic resonance (MR) image, but that may not be the proper test if the original differential diagnosis is faulty. Sedimentation rate and C-reactive protein may be more appropriate tests if the clinical facts suggest cranial arteritis. If carotid disease is suspected, a computed tomography (CT) angiogram may be more appropriate. In the following discussion of these defects, there has been a melding of a discussion explaining anatomically why these defects occur in certain areas. Because the course and relations of the primary visual sensory pathway have been frequently and well described (including in other chapters of this monograph), this chapter concentrates on the multiple anatomic substrates that may explain each particular pattern of visual field abnormality. Visual field abnormalities are represented by three categories: monocular, binocular, and junctional. Monocular field defects include those that can be caused by lesions of one eye or optic nerve. Binocular field defects include those that may result from single or multiple lesions at one or more points along the visual pathway. Junctional field defects include three types of visual field defects resulting from a lesion at the junction of the optic nerve and optic chiasm or of the optic tract and optic chiasm.


Visual Fields: Examination and Interpretation, 3rd edition contains revisions and updates of earlier material as well as a discussion of newer techniques for assessing visual field disorders. The book begins with a short history of the field of perimetry and goes on to present basic clinical aspects of examination and diagnosis of visual field defects in the optic nerve, optic disc, chorioretina, optic chiasm, optic tract, lateral geniculate field bodies, and the calcarine complex. Additional aspects of visual field examination are explored including those of monocular, binocular, and junctional field defects, congruity vs. incongruity, macular sparing vs. macular splitting, density, wedge-shaped homonymous field loss, and monocular temporal crescent. Various new techniques of automated perimetry are also considered including SITA, FASTPAC, and SWAP. This volume provides a very useful overview of the techniques of visual field examination in a number of eye disorders and will be of interest to all ophthalmologists, neuro-opthalmologists, retina specialists, and optometrists.


2021 ◽  
Vol 223 ◽  
pp. 229-240
Author(s):  
Eren Ekici ◽  
Sasan Moghimi ◽  
Huiyuan Hou ◽  
James Proudfoot ◽  
Linda M. Zangwill ◽  
...  

1998 ◽  
Vol 4 (2) ◽  
pp. 79-84 ◽  
Author(s):  
N Accornero ◽  
S Rinalduzzi ◽  
M Capozza ◽  
E Millefiorini ◽  
G C Filligoi ◽  
...  

Color visual field analysis has proven highly sensitive for early visual impairments diagnosis in MS, yet it has never attained widespread popularity usually because the procedure is difficult to standardize, the devices are costly, and the test is fatiguing. We propose a computerized procedure running on standard PC, cost effective, clonable, and easy handled. Two hundred and sixty-four colored patches subtending 18 angle of vision, with selected hues and low saturation levels are sequentially and randomly displayed on gray equiluminous background of the PC screen subtending 2486408 angle of vision. The subject is requested to press a switch at the perception of the stimulus. The output provides colored maps with quantitative information. Comparison between normals and a selected population of MS patients with no actual luminance visual field defects, showed high statistical difference.


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