scholarly journals Acute Zonal Occult Outer Retinopathy: Vision Loss in an Active Duty Soldier

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Courtney M. Crawford ◽  
Bruce A. Rivers ◽  
Mark Nelson

Objective. To describe a case of acute zonal occult outer retinopathy (AZOOR) in an active duty patient.Methods. In this paper we studied fundus photographs, optical coherence tomograph, Humphrey visual field 30-2, fundus autofluorescence images, fluorescein angiograms, and electroretinography.Results. Exam findings on presentation: a 34-year-old American Indian female presented with bilateral photopsias, early RPE irregularity, and an early temporal visual field defect. Progression RPE damage and visual field defect along with ERG findings support final diagnosis of AZOOR.Conclusion. AZOOR may initially be identified as a broader category of disease called the “AZOOR complex of disorders”. Specific visual field defects, ERG results, and clinical exam findings will help distinguish AZOOR from other similar disorders.

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Chan Hee Moon ◽  
Jungwoo Han ◽  
Young-Hoon Ohn ◽  
Tae Kwann Park

Purpose. To investigate the local relationship between quantified global-flash multifocal electroretinogram (mfERG) optic nerve head component (ONHC) and visual field defects in patients with glaucoma.Methods. Thirty-nine patients with glaucoma and 30 normal controls were enrolled. The ONHC amplitude was measured from the baseline to the peak of the second positive deflection of the induced component. The ONHC amplitude was normalized by dividing ONHC amplitude by the average of seven largest ONHC amplitudes. The ONHC amplitude ratio map and ONHC deficiency map were constructed. The local relationship between the ONHC measurements and visual field defects was evaluated by calculating the overlap between the ONHC deficiency maps and visual field defect plots.Results.The mean ONHC amplitude measurements of patients with glaucoma (6.01±1.91 nV/deg2) were significantly lower than those of the normal controls (10.29±0.94 nV/deg2) (P<0.001). The average overlap between the ONHC deficiency map and visual field defect plot was 71.4%. The highest overlap (75.0%) was between the ONHC ratios less than 0.5 and the total deviations less than 5%.Conclusions.The ONHC amplitude was reduced in patients with glaucoma compared to that in normal controls. Loss of the ONHC amplitude from the global-flash mfERG showed a high local agreement with visual field defects in patients with glaucoma.


BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025307
Author(s):  
Hong-Li Liu ◽  
Jia-Jia Yuan ◽  
Zhen Tian ◽  
Xin Li ◽  
Lin Song ◽  
...  

ObjectiveTo study the characteristics and progression of visual field defects in patients with Leber hereditary optic neuropathy.DesignProspective study.Setting3-A-class hospital in China; single-centre study.ParticipantsFrom 100 patients diagnosed with Leber hereditary optic neuropathy, 80 (160 eyes; 68 men and 12 women; youngest patient, 6 years; oldest patient, 35 years) were recruited.ExposureAll patients were followed up for at least 12 months. Each patient underwent at least three visual field examinations. Patient groups 1–6 were created according to the time of visual field data acquisition. Patient group 7 included patients with a different onset of disease between eyes. Group 8 was composed of patients with a course of disease of 12–24 months when one of the examinations performed. Patients who performed the third examination made up patient group 9.Primary outcome measuresPrevalence of the different visual field defect types on the basis of severity in groups 1–6. Mean of the difference of visual function between eyes in group 7.ResultIn groups 1–6, the prevalences of defects classified using Visual Field Index values were significantly different between groups 1 and 3. In group 7, with the prolongation of the course of the disease, the mean of the difference of visual function between eyes decreased. There was no significant correlation between age and the severity of visual field defect. There was significant correlation between visual acuity and the severity of visual field defect.ConclusionVisual field defects in patients with Leber hereditary optic neuropathy (G11778A) may continuously progress within 6 months of disease development, and remain stable after 9 months. With the progression of the disease, the differences in visual function between eyes may decrease. The severity of visual field defect seems to be independent of age; however, could be related to visual acuity.Trial registration numberNCT03428178,NCT01267422.


2021 ◽  
pp. 507-512
Author(s):  
Caberry W. Yu ◽  
Jonathan A. Micieli

Monocular visual field defects generally localize at or anterior to the optic chiasm, while homonymous hemianopias localize to the retrochiasmal visual pathway. Highly incongruous visual field defects may be difficult to identify on 24-2 Humphrey visual field testing, and this case demonstrates the value of optical coherence tomography (OCT) ganglion cell-inner plexiform layer (GCIPL) in rapidly localizing the lesion. A 54-year-old woman was found on routine examination to have an isolated superonasal quadrant visual field defect respecting the vertical meridian in the left eye only on Humphrey 24-2 SITA-Fast testing. She had a remote history of significant head trauma. Visual acuity, anterior segment, and fundus examination were normal. OCT revealed a bow-tie atrophy of the retinal nerve fiber layer in the right eye (OD), and binocular homonymous hemi-macular atrophy of OCT GCIPL, confirming the localization was the left retrochiasmal visual pathway. A repeat Humphrey 30-2 SITA-Fast visual field demonstrated that the visual field defect was also present in the OD in a highly incongruous manner. Magnetic resonance imaging of the brain with contrast showed mild atrophy of the left optic tract. This case demonstrates that highly incongruous visual field defects may be difficult to identify on Humphrey 24-2 SITA-Fast visual fields, and OCT GCIPL serves as a rapid way to localize the lesion. More detailed visual field testing including 30-2 programs should be considered in these cases.


2021 ◽  
pp. 569-573
Author(s):  
Aria Ghahramani ◽  
Mona L. Camacci ◽  
Rucha Borkhetaria ◽  
Anne Poulsen ◽  
Samuel Beckstead ◽  
...  

The aim of this report is to present a patient with traumatic optic nerve sheath hematoma (ONSH), a rare diagnosis with high potential for visual sequelae. This case involves a 41-year-old male who presented promptly following blunt trauma to the right eye and orbit that resulted in acute vision loss. Following computed tomography and ophthalmic examination, a diagnosis of ONSH was made and medical therapy with methylprednisolone was initiated. He reported significant improvements in visual symptoms following intravenous corticosteroid therapy. Although the patient reported significant improvements and had normal Snellen visual acuities in follow-up, he continued to have an inferior visual field defect at 1 week in the affected eye. ONSH causing subsequent localized compression of the optic nerve is a rare mechanism of traumatic optic neuropathy in patients following head trauma. The localized compartment syndrome of the optic nerve and subjective visual symptoms were relieved following corticosteroid therapy with no initial need for surgical decompression. Although central visual acuity returned to baseline, the patient had a persistent visual field defect and relative afferent pupillary defect.


2020 ◽  
Vol 11 ◽  
pp. 399
Author(s):  
Suyash Singh ◽  
Arun Kumar Srivastava ◽  
Sanjog Gajbhiye ◽  
Kamlesh Singh Bhaisora ◽  
Awadhesh Kumar Jaiswal ◽  
...  

Background: Occipital transtentorial approach for selected posterior third ventricular or retrosplenium region tumors provides an ergonomic and safe access. Over centuries, the opponents of this approach highlight the problem of postoperative visual field defect, related to the retraction of occipital lobe. The aim was to describe the surgical nuances of gravity-assisted retractor-less occipital-transtentorial approach (GAROTA) as a modification of originally described GAROTA to minimize the complications with a similar ease of surgery. Methods: In this study, we have retrospectively analyzed our prospectively maintained surgical databases of patients operated by occipito-transtentorial from 2015 to 2019. Demographic variables, preoperative and postoperative neurological deficits (especially visual field defect) were analyzed. Radiological data included relation of veins with tumor, presence of hydrocephalus, size, and extent of lesion. Results: Fifteen patients underwent GAROTA (right-sided extension, n = 7; left-sided extension, n = 4; and midline lesions, n = 4). Headaches (73.3%) and diplopia (40%) were the most common symptoms. No patient had any postoperative visual deficits in both short-term and long-term follow-up. Conclusion: A thorough anatomical knowledge of posterior third interhemispheric region in the semi-prone position is required for GAROTA. Meticulous arachnoid dissection around the deep venous complex and release of cerebrospinal fluid through the cisterns is required. Postoperative cortical vision loss may be prevented by following the key surgical principles in GAROTA.


Author(s):  
David Kuerten ◽  
Konstantin Kotliar ◽  
Matthias Fuest ◽  
Peter Walter ◽  
Muriel Hollstein ◽  
...  

Abstract Purpose Vascular risk factors and ocular perfusion are heatedly discussed in the pathogenesis of glaucoma. The retinal vessel analyzer (RVA, IMEDOS Systems, Germany) allows noninvasive measurement of retinal vessel regulation. Significant differences especially in the veins between healthy subjects and patients suffering from glaucoma were previously reported. In this pilot-study we investigated if localized vascular regulation is altered in glaucoma patients with altitudinal visual field defect asymmetry. Methods 15 eyes of 12 glaucoma patients with advanced altitudinal visual field defect asymmetry were included. The mean defect was calculated for each hemisphere separately (−20.99 ± 10.49 profound hemispheric visual field defect vs −7.36 ± 3.97 dB less profound hemisphere). After pupil dilation, RVA measurements of retinal arteries and veins were conducted using the standard protocol. The superior and inferior retinal vessel reactivity were measured consecutively in each eye. Results Significant differences were recorded in venous vessel constriction after flicker light stimulation and overall amplitude of the reaction (p < 0.04 and p < 0.02 respectively) in-between the hemispheres. Vessel reaction was higher in the hemisphere corresponding to the more advanced visual field defect. Arterial diameters reacted similarly, failing to reach statistical significance. Conclusion Localized retinal vessel regulation is significantly altered in glaucoma patients with asymmetric altitudinal visual field defects. Veins supplying the hemisphere concordant to a less profound visual field defect show diminished diameter changes. Vascular dysregulation might be particularly important in early glaucoma stages prior to a significant visual field defect.


2017 ◽  
Vol 43 (2) ◽  
pp. 124
Author(s):  
Ivana Tanoko ◽  
Fifin L Rahmi

Introduction and Objective: Glaucoma is the leading cause of global irreversible blindness, signed by glaucomatous optic neuropathy related to visual field defect. The purpose of the study is comparing visual field defect examination using HVFA to Amsler Grid in glaucoma patient at dr. Kariadi Hospital. Methods: This is a cross-sectional study. Amsler Grid were performed to the patients who have reliable HVFA at last 6 months and presented as descriptive analytic results. Result: There were 40 eyes involved in this study from 27 patients (15 men, 12 women), 26-68 years old and visual acuity 1/60-6/6. Seventeen eyes showed visual field defect in HVFA and Amsler Grid had average MD - 24.97 dB, CDR 0.89 and RNFL thickness 51.74. We found that 11 eyes didn’t showed in both of examination had average MD -8.06, CDR 0.63 and RNFL thickness 103.23 and those parameters are significantly different to the 17 eyes before (p<0.05). Data from 12 eyes that showed visual field defect only one of examination (9 only in HVFA and 3 in Amsler Grid) didn’t show difference statistically each other. Conclusion: HFVA and Amsler Grid seemed to be comparable in detecting visual field defect in advanced glaucoma.


Author(s):  
David Kuerten ◽  
Matthias Fuest ◽  
Peter Walter ◽  
Babac Mazinani ◽  
Niklas Plange

Abstract Purpose To investigate the relationship of ocular blood flow (via arteriovenous passage time, AVP) and contrast sensitivity (CS) in healthy as well as normal tension glaucoma (NTG) subjects. Design Mono-center comparative prospective trial Methods Twenty-five NTG patients without medication and 25 healthy test participants were recruited. AVP as a measure of retinal blood flow was recorded via fluorescein angiography after CS measurement using digital image analysis. Association of AVP and CS at 4 spatial frequencies (3, 6, 12, and 18 cycles per degree, cpd) was explored with correlation analysis. Results Significant differences regarding AVP, visual field defect, intraocular pressure, and CS measurement were recorded in-between the control group and NTG patients. In NTG patients, AVP was significantly correlated to CS at all investigated cpd (3 cpd: r =  − 0.432, p< 0.03; 6 cpd: r =  − 0.629, p< 0.0005; 12 cpd: r =  − 0.535, p< 0.005; and 18 cpd: r =  − 0.58, p< 0.001), whereas no significant correlations were found in the control group. Visual acuity was significantly correlated to CS at 6, 12, and 18 cpd in NTG patients (r =  − 0.68, p< 0.002; r =  − 0.54, p< .02, and r =  − 0.88, p< 0.0001 respectively), however not in healthy control patients. Age, visual field defect MD, and PSD were not significantly correlated to CS in in the NTG group. MD and PSD were significantly correlated to CS at 3 cpd in healthy eyes (r = 0.55, p< 0.02; r =  − 0.47, p< 0.03). Conclusion Retinal blood flow alterations show a relationship with contrast sensitivity loss in NTG patients. This might reflect a disease-related link between retinal blood flow and visual function. This association was not recorded in healthy volunteers.


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