Visual field loss and structure–function relationships in optic neuritis associated with myelin oligodendrocyte glycoprotein antibody

2020 ◽  
pp. 135245852093728
Author(s):  
Romain Deschamps ◽  
Manon Philibert ◽  
Cedric Lamirel ◽  
Jerome Lambert ◽  
Vivien Vasseur ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Neuritis ◽  
Structural Damage ◽  
Structural Changes ◽  
Visual Field Loss ◽  
Visual Outcome ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Mean Deviation ◽  
Ophthalmological Examination ◽  
Fiber Layer

Background: A paradoxical discrepancy between severe peripapillary retinal nerve fiber layer (pRNFL) atrophy and good visual outcome had been reported in patients with myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG)-associated optic neuritis (ON). However, only visual acuity (VA) was assessed. Objectives: To study visual field (VF) outcomes of patients with MOG-IgG-associated ON and evaluate the correlation between functional eye outcome and retinal structural changes assessed by optical coherence tomography. Methods: The records of 32 patients with MOG-IgG-associated ON who underwent ophthalmological examination at least 12 months after ON onset were reviewed. Degree of VF disability was determined by mean deviation (MD). Results: At final assessment (median, 35 months), 4.2% of 48 affected eyes (AE) had VA ⩽ 0.1, 40% had abnormal MD, and among AE with final VA ⩾ 1.0, 31% had mild to moderate damage. Thinning of the inner retinal layers was significantly correlated with MD impairment. Analysis demonstrated a threshold of pRNFL thickness (50 µm), below which MD was significantly worse (mean, −2.27 dB vs −17.72 dB; p = 0.0003). ON relapse was significantly associated with poor visual outcome assessed by MD. Conclusion: Functional impairment measured with VF is not rare, and MD assessment better reflects actual structural damage.

scholarly journals MS optic neuritis-induced long-term structural changes within the visual pathway

2020 ◽  
Vol 7 (2) ◽  
pp. e665 ◽  
Author(s):  
Marc Pawlitzki ◽  
Marc Horbrügger ◽  
Kristian Loewe ◽  
Jörn Kaufmann ◽  
Roland Opfer ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Structural Damage ◽  
Structural Changes ◽  
Visual Pathway ◽  
System Structure ◽  
Pattern Reversal ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
History Of

BackgroundThe visual pathway is commonly involved in multiple sclerosis (MS), even in its early stages, including clinical episodes of optic neuritis (ON). The long-term structural damage within the visual compartment in patients with ON, however, is yet to be elucidated.ObjectiveOur aim was to characterize visual system structure abnormalities using MRI along with optical coherence tomography (OCT) and pattern-reversal visual evoked potentials (VEPs) depending on a single history of ON.MethodsTwenty-eight patients with clinically definitive MS, either with a history of a single ON (HON) or without such history and normal VEP findings (NON), were included. OCT measures comprised OCT-derived peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell/inner plexiform layer (GCIPL) thickness. Cortical and global gray and white matter, thalamic, and T2 lesion volumes were assessed using structural MRI. Diffusion-weighted MRI-derived measures included fractional anisotropy (FA), mean (MD), radial (RD), and axial (AD) diffusivity within the optic radiation (OR).ResultsMean (SD) duration after ON was 8.3 (3.7) years. Compared with the NON group, HON patients showed significant RNFL (p = 0.01) and GCIPL thinning (p = 0.002). OR FA (p = 0.014), MD (p = 0.005), RD (p = 0.007), and AD (p = 0.004) were altered compared with NON. Global gray and white as well as other regional gray matter structures did not differ between the 2 groups.ConclusionA single history of ON induces long-term structural damage within the retina and OR suggestive of both retrograde and anterograde neuroaxonal degeneration.

Long-term visual outcome after microsurgical removal of occipital lobe cavernomas

2012 ◽  
Vol 117 (2) ◽  
pp. 295-301 ◽  
Author(s):  
Juri Kivelev ◽  
Elina Koskela ◽  
Kirsi Setälä ◽  
Mika Niemelä ◽  
Juha Hernesniemi
Keyword(s):  
Visual Field ◽  
Visual Fields ◽  
Visual Field Loss ◽  
Occipital Lobe ◽  
Visual Outcome ◽  
Surgical Removal ◽  
Long Term Outcome ◽  
Visual Field Deficit

Object Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatment of occipital cavernomas with special emphasis on visual outcome. Methods Of the 390 consecutive patients with cavernomas who were treated at Helsinki University Central Hospital between 1980 and 2011, 19 (5%) had occipital cavernomas. Sixteen patients (4%) were surgically treated and are included in this study. The median age was 39 years (range 3–59 years). Seven patients (56%) suffered from hemorrhage preoperatively, 5 (31%) presented with visual field deficits, 11 (69%) suffered from seizures, and 4 (25%) had multiple cavernomas. Surgery was indicated for progressive neurological deterioration. The median follow-up after surgery was 5.25 years (range 0.5–14 years). Results All patients underwent thorough neuroophthalmological assessment to determine visual outcome after surgery. Visual fields were classified as normal, mild homonymous visual field loss (not disturbing the patient, driving allowed), moderate homonymous visual field loss (disturbing the patient, driving prohibited), and severe visual field loss (total homonymous hemianopia or total homonymous quadrantanopia). At the last follow-up, 4 patients (25%) had normal visual fields, 6 (38%) had a mild visual field deficit, 1 (6%) complained of moderate visual field impairment, and 5 (31%) had severe homonymous visual field loss. Cavernomas seated deeper than 2 cm from the pial surface carried a 4.4-fold risk of postoperative visual field deficit relative to superficial ones (p = 0.034). Six (55%) of the 11 patients presenting with seizures were seizure-free postoperatively. Eleven (69%) of 16 patients had no disability during the long-term follow-up. Conclusions Surgical removal of occipital cavernomas may carry a significant risk of postoperative visual field deficit, and the risk is even higher for deeper lesions. Seizure outcome after removal of these cavernomas appeared to be worse than that after removal in other supratentorial locations. This should be taken into account during preoperative planning.

scholarly journals Optic Disc Vascularization in Glaucoma: Value of Spectral-Domain Optical Coherence Tomography Angiography

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Pierre-Maxime Lévêque ◽  
Pierre Zéboulon ◽  
Emmanuelle Brasnu ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Visual Field ◽  
Univariate Analysis ◽  
Normal Subjects ◽  
Vessel Density ◽  
Spectral Domain ◽  
Control Group ◽  
Mean Deviation ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Spectral Domain Oct

Purpose. To detect changes in optic nerve head (ONH) vascularization in glaucoma patients using spectral-domain OCT angiography (OCT-A).Material and Method. Fifty glaucoma patients and 30 normal subjects were evaluated with OCT-A (AngioVue®, Optovue). The total ONH vessel density and temporal disc vessel density were measured. Clinical data, visual field (VF) parameters, and spectral-domain OCT evaluation (RNFL: retinal nerve fiber layer thickness, GCC: ganglion cell complex thickness, and rim area) were recorded for glaucoma patients. Correlations among total and temporal ONH vessel density and structural and VF parameters were analyzed.Results. In the glaucoma group, total and temporal ONH vessel density were reduced by 24.7% (0.412 versus 0.547;p<0.0001) and 22.88% (0.364 versus 0.472;p=0.001), respectively, as compared with the control group. Univariate analysis showed significant correlation between rim area (mm2) and temporal ONH vessel density (r=0.623;p<0.0001) and total ONH vessel density (r=0.609;p<0.0001). Significant correlations were found between temporal and total ONH vessel density and RNFL, GCC, VF mean deviation, and visual field index.Conclusion. In glaucoma patients OCT-A might detect reduced ONH blood vessel density that is associated with structural and functional glaucomatous damage. OCT-A might become a useful tool for the evaluation of ONH microcirculation changes in glaucoma.

scholarly journals Visual Field Mean Deviation at Diagnosis of Idiopathic Intracranial Hypertension Predicts Visual Outcome

2019 ◽  
Vol 39 (2) ◽  
pp. 186-190 ◽  
Author(s):  
Shravani Mikkilineni ◽  
Jonathan D. Trobe ◽  
Wayne T. Cornblath ◽  
Lindsey De Lott
Keyword(s):  
Visual Field ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Visual Outcome ◽  
Mean Deviation

Automated Perimetry in Glaucoma

Visual Fields ◽  
2010 ◽  
Author(s):  
Hylton R. Mayer ◽  
Marc L. Weitzman
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Nerve Fiber ◽  
Optic Disc ◽  
Structural Damage ◽  
Visual Field Defects ◽  
Fiber Layer ◽  
Glaucomatous Damage ◽  
Retinal Fibers ◽  
Field Defects

Clinical experience and multiple prospective studies, such as the Collaborative Normal Tension Glaucoma Study and the Los Angeles Latino Eye Study, have demonstrated that the diagnosis of glaucoma is more complex than identifying elevated intraocular pressure. As a result, increased emphasis has been placed on measurements of the structural and functional abnormalities caused by glaucoma. The refinement and adoption of imaging technologies assist the clinician in the detection of glaucomatous damage and, increasingly, in identifying the progression of structural damage. Because visual field defects in glaucoma patients occur in patterns that correspond to the anatomy of the nerve fiber layer of the retina and its projections to the optic nerve, visual functional tests become a link between structural damage and functional vision loss. The identification of glaucomatous damage and management of glaucoma require appropriate, sequential measurements and interpretation of the visual field. Glaucomatous visual field defects usually are of the nerve fiber bundle type, corresponding to the anatomic arrangement of the retinal nerve fiber layer. It is helpful to consider the division of the nasal and temporal retina as the fovea, not the optic nerve head, because this is the location that determines the center of the visual field. The ganglion cell axon bundles that emanate from the nasal side of the retina generally approach the optic nerve head in a radial fashion. The majority of these fibers enter the nasal half of the optic disc, but fibers that represent the nasal half of the macula form the papillomacular bundle to enter the temporal-most aspect of the optic nerve. In contrast, the temporal retinal fibers, with respect to fixation, arc around the macula to enter the superotemporal and inferotemporal portions of the optic disc. The origin of these arcuate temporal retinal fibers strictly respects the horizontal retinal raphe, temporal to the fovea. As a consequence of this superior-inferior segregation of the temporal retinal fibers, lesions that affect the superotemporal and inferotemporal poles of the optic disc, such as glaucoma, tend to cause arcuateshaped visual field defects extending from the blind spot toward the nasal horizontal meridian.

scholarly journals Estimating Rates of Progression and Predicting Future Visual Fields in Glaucoma Using a Deep Variational Autoencoder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Samuel I. Berchuck ◽  
Sayan Mukherjee ◽  
Felipe A. Medeiros
Keyword(s):  
Visual Field ◽  
Learning Algorithm ◽  
Visual Fields ◽  
Visual Field Loss ◽  
Absolute Error ◽  
Rate Of Change ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Deep Learning Algorithm

AbstractIn this manuscript we develop a deep learning algorithm to improve estimation of rates of progression and prediction of future patterns of visual field loss in glaucoma. A generalized variational auto-encoder (VAE) was trained to learn a low-dimensional representation of standard automated perimetry (SAP) visual fields using 29,161 fields from 3,832 patients. The VAE was trained on a 90% sample of the data, with randomization at the patient level. Using the remaining 10%, rates of progression and predictions were generated, with comparisons to SAP mean deviation (MD) rates and point-wise (PW) regression predictions, respectively. The longitudinal rate of change through the VAE latent space (e.g., with eight dimensions) detected a significantly higher proportion of progression than MD at two (25% vs. 9%) and four (35% vs 15%) years from baseline. Early on, VAE improved prediction over PW, with significantly smaller mean absolute error in predicting the 4th, 6th and 8th visits from the first three (e.g., visit eight: VAE8: 5.14 dB vs. PW: 8.07 dB; P < 0.001). A deep VAE can be used for assessing both rates and trajectories of progression in glaucoma, with the additional benefit of being a generative technique capable of predicting future patterns of visual field damage.

scholarly journals Estimating Visual Field Mean Deviation using Optical Coherence Tomographic Nerve Fiber Layer Measurements in Glaucoma Patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ou Tan ◽  
David S. Greenfield ◽  
Brian A. Francis ◽  
Rohit Varma ◽  
Joel S. Schuman ◽  
...  
Keyword(s):  
Visual Field ◽  
Nerve Fiber ◽  
Weighted Averaging ◽  
Mean Deviation ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Maximal Correlation ◽  
Advanced Stages ◽  
Higher Sensitivity

AbstractTo construct an optical coherence tomography (OCT) nerve fiber layer (NFL) parameter that has maximal correlation and agreement with visual field (VF) mean deviation (MD). The NFL_MD parameter in dB scale was calculated from the peripapillary NFL thickness profile nonlinear transformation and VF area-weighted averaging. From the Advanced Imaging for Glaucoma study, 245 normal, 420 pre-perimetric glaucoma (PPG), and 289 perimetric glaucoma (PG) eyes were selected. NFL_MD had significantly higher correlation (Pearson R: 0.68 vs 0.55, p < 0.001) with VF_MD than the overall NFL thickness. NFL_MD also had significantly higher sensitivity in detecting PPG (0.14 vs 0.08) and PG (0.60 vs 0.43) at the 99% specificity level. NFL_MD had better reproducibility than VF_MD (0.35 vs 0.69 dB, p < 0.001). The differences between NFL_MD and VF_MD were −0.34 ± 1.71 dB, −0.01 ± 2.08 dB and 3.54 ± 3.18 dB and 7.17 ± 2.68 dB for PPG, early PG, moderate PG, and severe PG subgroups, respectively. In summary, OCT-based NFL_MD has better correlation with VF_MD and greater diagnostic sensitivity than the average NFL thickness. It has better reproducibility than VF_MD, which may be advantageous in detecting progression. It agrees well with VF_MD in early glaucoma but underestimates damage in moderate~advanced stages.

scholarly journals Bilateral retinal pathology following a first-ever clinical episode of autoimmune optic neuritis

2020 ◽  
Vol 7 (2) ◽  
pp. e671 ◽  
Author(s):  
Carla A. Wicki ◽  
Praveena Manogaran ◽  
Tanja Simic ◽  
James V.M. Hanson ◽  
Sven Schippling
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Structural Damage ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
Low Contrast ◽  
Time Points ◽  
Acute Optic Neuritis ◽  
Retinal Pathology ◽  
Clinical Episode

ObjectiveThis longitudinal study aimed to assess changes in retinal structure and visual function following a first-ever episode of acute optic neuritis (ON).MethodsClinical and optical coherence tomography (OCT) data obtained over a period of 12 months were retrospectively analyzed in 41 patients with a first-ever clinical episode of acute ON. OCT scans, high-contrast visual acuity (HCVA), and low-contrast visual acuity (LCVA) were acquired at baseline and at 1, 3, 6, and 12 months thereafter. Macular ganglion cell and inner plexiform layer (GCIP), peripapillary retinal nerve fiber layer (pRNFL), and macular inner nuclear layer (INL) thicknesses were assessed by OCT. Linear mixed-effects models were used to analyze OCT variables of ipsilateral ON and contralateral non-ON (NON) eyes over time.ResultsThe mean change of GCIP thickness in ON eyes was significant at all follow-up time points, with nearly 75% of the total reduction having occurred by month 1. In ON eyes, thinner GCIP thickness at month 1 correlated with lower LCVA at month 3. Mean pRNFL thickness in ON eyes differed significantly from NON eyes at all postbaseline time points. INL thickness was significantly increased in ON eyes (month 1) but also in contralateral NON eyes (month 12).ConclusionsRetinal structural damage develops rapidly following acute ON and is associated with subsequent functional visual deficits. Our results also suggest bilateral retinal pathology following unilateral ON, possibly caused by subclinical involvement of the contralateral NON eyes. Moreover, our data may assist in clinical trial planning in studies targeting tissue damage in acute ON.

scholarly journals Peripapillary Retinal Nerve Fiber Layer Vascular Microcirculation in Eyes With Glaucoma and Single-Hemifield Visual Field Loss

2017 ◽  
Vol 135 (5) ◽  
pp. 461 ◽  
Author(s):  
Chieh-Li Chen ◽  
Karine D. Bojikian ◽  
Joanne C. Wen ◽  
Qinqin Zhang ◽  
Chen Xin ◽  
...  
Keyword(s):  
Visual Field ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Visual Field Loss ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Retinal Nerve Fiber

scholarly journals Parafoveal and Peripapillary Perfusion Predict Visual Field Recovery in Chiasmal Compression due to Pituitary Tumors

2020 ◽  
Vol 9 (3) ◽  
pp. 697 ◽  
Author(s):  
Ga-In Lee ◽  
Kyung-Ah Park ◽  
Sei Yeul Oh ◽  
Doo-Sik Kong
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Pituitary Tumors ◽  
Vessel Density ◽  
Mean Deviation ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Chiasmal Compression ◽  
Retinal Capillary ◽  
Capillary Plexus

Background: To evaluate the potential of vessel density alterations for predicting postoperative visual field (VF) improvement in chiasmal compression using optical coherence tomography angiography (OCT-A). Methods: The study investigated 57 eyes of 57 patients diagnosed with pituitary tumors and 42 eyes of 42 age and refractive error matched controls. All eyes with chiasmal compression for which preoperative optical coherence tomography (OCT) and OCT-A, and pre- and postoperative VF data were available. Preoperative vessel densities of superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment were utilized by OCT-A. Results: Preoperative peripapillary retinal nerve fiber layer and ganglion cell layer complex thickness and vessel densities of SRCP and RPC segments in eyes with chiasmal compression were significantly reduced compared with healthy controls (p < 0.001, p < 0.001, p = 0.007, and p = 0.020, respectively). In multivariate regression analysis, preoperative perimetric mean deviation (MD) (p = 0.002) and vessel density of SRCP (p = 0.025) were correlated significantly with postoperative perimetric MD. Spearman’s correlation analysis revealed significant correlations between preoperative MD on perimetry (r = 0.443, p = 0.001), vessel densities of SRCP (r = 0.288, p = 0.035) and RPC segment (r = 0.347, p = 0.009), and postoperative perimetric MD. Conclusions: Structural degeneration referred to as microvascular alterations measured by OCT-A and preoperative VF defects were associated with worse postoperative VF prognosis. Parafoveal and peripapillary vessel densities may serve as a sensitive, structural prognostic factors in the preoperative judgement of chiasmal compression.

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