Distracted Driving and Driving Patterns in Older Drivers With Glaucoma

2021 ◽  
pp. 155982762110428
Author(s):  
Purva Jain ◽  
Jonathan T. Unkart ◽  
Fabio B. Daga ◽  
Linda Hill
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Fields ◽  
Distracted Driving ◽  
Night Vision ◽  
Driving Ability ◽  
Safe Driving ◽  
Ability To Drive ◽  
Acuity Score

Limited research exists examining self-perceived vision and driving ability among individuals with glaucoma, and this study assessed the relationship between glaucoma, visual field, and visual acuity with driving capability. 137 individuals with glaucoma and 75 healthy controls were asked to evaluate self-rated vision, self-perceived driving ability, and self-perceived distracted driving. Visual acuity and visual field measurements were also obtained. Multivariable linear regressions were run to test each visual measure with driving outcomes. The average age was 72.2 years, 57.3% were male, and 72.5% were White. There were significant associations for a one-point increase in visual field and quality of corrected vision (RR = 1.06; 95% CI = 1.03–1.10), day vision (RR = 1.05; 95% CI = 1.03–1.08), night vision (RR = 1.08; 95% CI = 1.05–1.13), visual acuity score and higher quality of corrected of vision (RR = .41; 95% CI = .22-.77), day vision (RR = .39; 95% CI=.22–.71), and night vision (RR = .41; 95% CI = .18–.94); visual acuity score and ability to drive safely compared to other drivers your age (RR = .53; 95% CI = .29–.96). Individuals with poorer visual acuity and visual fields rate their vision and ability to drive lower than those with better vision, and this information will allow clinicians to understand where to target interventions to enhance safe driving practices.

Arteriovenous malformations in the optic apparatus: systematic literature review and report of four cases

2021 ◽  
pp. 1-11
Author(s):  
Visish M. Srinivasan ◽  
Phiroz E. Tarapore ◽  
Stefan W. Koester ◽  
Joshua S. Catapano ◽  
Caleb Rutledge ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Function ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Visual Fields ◽  
Optic Tract ◽  
Visual Disturbance ◽  
Visual Field Defects ◽  
Subtotal Resection

OBJECTIVE Rare arteriovenous malformations (AVMs) of the optic apparatus account for < 1% of all AVMs. The authors conducted a systematic review of the literature for cases of optic apparatus AVMs and present 4 cases from their institution. The literature is summarized to describe preoperative characteristics, surgical technique, and treatment outcomes for these lesions. METHODS A comprehensive search of the English-language literature was performed in accordance with established Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all published cases of AVM in the optic apparatus in the PubMed, Web of Science, and Cochrane databases. The authors also searched their prospective institutional database of vascular malformations for such cases. Data regarding the clinical and radiological presentation, visual acuity, visual fields, extent of resection, and postoperative outcomes were gathered. RESULTS Nine patients in the literature and 4 patients in the authors’ single-surgeon series who fit the inclusion criteria were identified. The median age at presentation was 29 years (range 8–39 years). Among these patients, 11 presented with visual disturbance, 9 with headache, and 1 with multiple prior subarachnoid hemorrhages; the AVM in 1 case was found incidentally. Four patients described prior symptoms of headache or visual disturbance consistent with sentinel events. Visual acuity was decreased from baseline in 10 patients, and 11 patients had visual field defects on formal visual field testing. The most common visual field defect was temporal hemianopia, found in one or both eyes in 7 patients. The optic chiasm was affected in 10 patients, the hypothalamus in 2 patients, the optic nerve (unilaterally) in 8 patients, and the optic tract in 2 patients. Six patients underwent gross-total resection; 6 patients underwent subtotal resection; and 1 patient underwent craniotomy, but no resection was attempted. Postoperatively, 9 of the patients had improved visual function, 1 had no change, and 3 had worse visual acuity. Eight patients demonstrated improved visual fields, 1 had no change, and 4 had narrowed fields. CONCLUSIONS AVMs of the optic apparatus are rare lesions. Although they reside in a highly eloquent region, surgical outcomes are generally good; the majority of patients will see improvement in their visual function postoperatively. Microsurgical technique is critical to the successful removal of these lesions, and preservation of function sometimes requires subtotal resection of the lesion.

scholarly journals Novel Pathogenic Sequence Variants in NR2E3 and Clinical Findings in Three Patients

Genes ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 1288
Author(s):  
Saoud Al-khuzaei ◽  
Suzanne Broadgate ◽  
Stephanie Halford ◽  
Jasleen K. Jolly ◽  
Morag Shanks ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Fields ◽  
Visual Field Loss ◽  
Clinical Findings ◽  
Sequence Variants ◽  
Childhood Onset ◽  
Distinctive Features ◽  
Targeted Ngs ◽  
Clinical Records

A retrospective review of the clinical records of patients seen at the Oxford Eye Hospital identified as having NR2E3 mutations was performed. The data included symptoms, best-corrected visual acuity, multimodal retinal imaging, visual fields and electrophysiology testing. Three participants were identified with biallelic NR2E3 pathogenic sequence variants detected using a targeted NGS gene panel, two of which were novel. Participant I was a Nepalese male aged 68 years, and participants II and III were white Caucasian females aged 69 and 10 years old, respectively. All three had childhood onset nyctalopia, a progressive decrease in central vision, and visual field loss. Patients I and III had photopsia, patient II had photosensitivity and patient III also had photophobia. Visual acuities in patients I and II were preserved even into the seventh decade, with the worst visual acuity measured at 6/36. Visual field constriction was severe in participant I, less so in II, and fields were full to bright targets targets in participant III. Electrophysiology testing in all three demonstrated loss of rod function. The three patients share some of the typical distinctive features of NR2E3 retinopathies, as well as a novel clinical observation of foveal ellipsoid thickening.

scholarly journals Visual Field Defect after Cardiac Surgery: The Striking Role of Interdisciplinary Collaboration

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Raffaele Nuzzi ◽  
Carlo Lavia
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Interdisciplinary Collaboration ◽  
Visual Fields ◽  
Cortical Blindness ◽  
Visual Field Defects ◽  
Ischemic Optic Neuropathy ◽  
Intraoperative Hypotension ◽  
Perioperative Visual Loss ◽  
Vascular Occlusions

Perioperative visual loss (POVL) is a potentially devastating complication that can occur following ocular or nonocular surgery. The leading causes of this disease are retinal vascular occlusions, ischemic optic neuropathies, and cortical blindness. POVL pathogenesis is strictly influenced by surgery, anesthesia, and patients’ comorbidities. We report of a 55-year-old caucasian man who presented with complaints of sudden painless loss of vision and unilateral campimetric deficit. We recorded a preserved visual acuity but at fundus examination a bilateral ischemic optic neuropathy (ION) was suspected. Our hypothesis was supported by uncommon and peculiar visual field defects and a history of cardiovascular surgery shortly before was a striking data. When we examined his medical records we found strong accordance with what is reported in literature to be risk factors for postoperative ION development. He presented intraoperative hypotension, anemia, and hypothermia, he was older than 50 years, and surgery lasted for more than five hours. We are currently monitoring his visual acuity and visual fields which remain unchanged. As there is no proved therapy for such severe adverse events, we recommend intraoperative check of blood pressure, blood loss, and body temperature, associated with repeated eye checks and patients’ interview.

Letter Structure Factors in the Recognition of Alphabetical Arrays Presented in the Right and Left Visual Fields

1970 ◽  
Vol 31 (2) ◽  
pp. 555-559
Author(s):  
Robert Fudin
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Fields ◽  
Structure Factors ◽  
The Right

Six-letter nonsense arrays made up of the letters H N Z D W J were tachistoscopically exposed either to the right or left of fixation at four displacements to 20 Ss. Structurally similar letters (i.e., the H and N) tended to be recognized with greater difficulty than dissimilar items. Following certain ideas about scanning (Fudin, 1969), the possible effect of letter structure was investigated separately in the first half of targets (letters 1, 2, and 3) and in the last half. This effect was almost exclusively limited to the array-half at each displacement which, because of its position in the visual field, fell in an area of greater visual acuity. Further research concerning the influence of letter structure upon recognition whenever stimuli are briefly presented seems warranted.

scholarly journals The anterior ischemic optic neuropathy treatment using the dispersed “Alloplant”

2013 ◽  
Vol 6 (2) ◽  
pp. 20-24
Author(s):  
Venera Uzbekovna Galimova ◽  
Irina Viktorovna Verzakova ◽  
Yevgeniy Musinovich Gareyev ◽  
Zarina Khikhmetullovna Karimova
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Blood Supply ◽  
Optic Neuropathy ◽  
Visual Fields ◽  
Resistance Index ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Ciliary Arteries ◽  
Lateral Branches

In this article, the results of a study are presented on the influence of the therapeutic retroscleral filling by dispersed “Alloplant” biomaterial upon blood supply and visual functions of the eye. 47 patients (69 eyes) suffering from anterior ischemic optic neuropathy sequelae were examined. Obtained results allowed to study the degree of relationship between the following indices: resistance index of ocular vessels, visual acuity and electrophysiological data, visual field limits. The majority of cases with significant visual fields widening (79 %) correlated with post-operative decrease of resistance index in posterior short ciliary arteries (medial and lateral branches). The results of performed investigation allow to assume that the dispersed “Alloplant” biomaterial use in the treatment of patients with anterior ischemic optic neuropathy sequelae could promote the optic nerve blood supply improvement with further amelioration of visual function indices.

scholarly journals Microsurgical Management of Tuberculum Sellae Meningiomas by the supraorbital keyhole eyebrow approach: Surgical Outcome

2017 ◽  
Vol 14 (3) ◽  
pp. 26-32
Author(s):  
Robin Bhattarai ◽  
Liang CaoFeng ◽  
Guo Ying
Keyword(s):  
Visual Acuity ◽  
Visual Fields ◽  
Visual Outcome ◽  
Skin Incision ◽  
Impairment Score ◽  
Eyebrow Incision ◽  
Tuberculum Sellae ◽  
The Mean

The aim of this study was to evaluate (surgical) visual outcomes in patients treated via supraorbital keyhole eyebrow incision approach. Data from 14 patients with TSMs (Tuberculum Sellae Meningioma) who underwent microsurgical treatment by a supraorbital keyhole eyebrow skin incision between September 2006 and September 2013 were retrospectively collected and analyzed. Patients were analyzed on the basis of clinical, radiological, and surgical factors that appeared to affect the outcome. To quantify the extent of ophthalmological disturbances Visual impairment score was used to analyze visual acuity and visual fields, which range from 0 (best) to 100 (worst). Change in visual function was assessed as the main outcome. The mean age of the 10 women and 4 men enrolled in the study was 56.50years (range, 42~74 years). The presenting symptom was asymmetrical visual loss in 71.4% of the patients.And examination revealed decreased visual acuity (Snellen notation) in 100% and impaired visual fields (Goldmann perimetry) in 58.3 % (7/12 cases, central scotoma and temporal anopia n=1, classical bitemporal hemianopia n=4, incongruent homonymous hemianopia n=2 , 2 cases data N/A) of the patients. Simpson grades I resection via a supraorbital keyhole eyebrow skin incision approach, were achieved in 100% of the patients. Quality of life was assessed according to Karnofsky scale and was 86.67 (range: 70~100). The mean follow-up duration was 51.73 months (range: 27~91 months).No recurrent tumors were observed during this period. According to the findings of this study, this approach provides a pleasing cosmetic outcome and also decreases brain manipulation while minimizing the likelihood of procedure-related morbidity. A favorable visual outcome was observed in most of the patients in the late postoperative period. Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, page : 26-32

Detecting Visual Field Progression in Glaucoma – Using the Right Tools for the Job

2013 ◽  
Vol 07 (01) ◽  
pp. 20 ◽  
Author(s):  
Luke J Saunders ◽  
Richard A Russell ◽  
David P Crabb ◽  
◽  
◽  
...  
Keyword(s):  
Visual Field ◽  
Visual Fields ◽  
Field Measurements ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Visual Disability ◽  
New Research ◽  
The Right ◽  
Over Time

Monitoring disease progression is at the centre of managing a patient with glaucoma. This article focuses specifically on how visual field measurements from standard automated perimetry (SAP) can be monitored over time. Various options for analysis on the Humphrey and Octopus perimeters are discussed, from summary indices to event and trend-based analyses; their respective merits and flaws evaluated. It is strongly recommended that quantitative analysis methods and software are used in assessing progression, as variability in threshold measurements makes detecting true deterioration non-trivial. Recommendations on the frequency of visual fields that should be taken per year are also discussed. The article concludes by putting the spotlight on new research being undertaken to improve the methods of measuring and predicting progression, as well as relating visual fields to patient visual disability and quality of life.

Reading Speed under Real and Simulated Visual Impairment

1983 ◽  
Vol 77 (8) ◽  
pp. 386-388 ◽  
Author(s):  
Christof C. Krischer ◽  
Ralf Meissen
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Impairment ◽  
Reading Speed ◽  
Visual Fields ◽  
Central Field ◽  
Normal Visual Field ◽  
Partially Sighted

The reading speed of subjects was studied under conditions of simulated and real visual impairment. For subjects with normal visual field and average reading speeds, two types of visual impairment were simulated: cataracts and deteriorated retinas. Three groups of partially sighted persons also were studied: those with normal visual fields, those with defects in peripheral fields, and those with defects in the central field. The results for these three groups were similar to those obtained under conditions of simulated visual impairment. The authors conclude that reading speed depends on visual acuity.

scholarly journals Trans-ophthalmic Arterial Ethanol Embolotherapy for Arteriovenous Malformations: A Single Centre Experience

2021 ◽  
Author(s):  
Xin-yu Li ◽  
Xi-tao Yang
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Vision Loss ◽  
Visual Field Defects ◽  
Complete Relief ◽  
Life Outcomes ◽  
Single Centre ◽  
Permanent Disability ◽  
Single Centre Experience

Abstract Background and purposeArteriovenous malformations (AVMs) derived ophthalmic artery (OphA) branches are not common, however, their management is very challenging. We aimed at evaluating the safety and efficacy of Trans OphA ethanol embolotherapy for these lesions.Materials and methodsWe retrospectively reviewed 26 patients with AVMs fed by OphA, who underwent transOphA embolization using ethanol from February, 2015 to December, 2019. Sixty-six transOphA embolotherapy procedures (range, 1-4 procedures; mean, 2.5 procedures) were performed. Degree of devascularization, visual field, visual acuity, and quality-of-life outcomes were compared and analyzed at follow ups (mean, 32.6 months; month range 10-60). Complications were recorded.ResultsTwenty of the 26 patients (77%) reported complete or >90% AVM devascularization while six patients (23%) showed >70% devascularization. Eleven patients (42%) presented with visual acuity impairments with 4 complete relief, 6 improvements. Eight patients (42%) presented visual field defects with 4 complete relief, 3 with improvements. Ten patients (38.4%) presented with diplopia and exophthalmos with 2 complete relief, 6 major improvements. Bleeding was controlled in all cases (100%). All patients (100%) exhibited cosmetic deformities with 17 being completely relieved. Moreover, all patients (100%) exhibited impaired daily life, which was resolved in 21 patients with 5 patients reporting major improvements. No vision loss, death, or permanent disability in all patients.ConclusionsTransOphA ethanol embolotherapy was found to be efficacious, safe and it achieved symptomatic resolution or improvement of AVMs fed by OphA with acceptable complications without the risk of visual impairment.

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