scholarly journals Ipsilateral Vs Controlateral Approach in Tuberculum Sellae Meningiomas Surgery. A Retrospective Comparative Study

2021 ◽  
Author(s):  
Lucas Troude ◽  
Mohamed Boucekine ◽  
Guillaume Baucher ◽  
Kaissar Farah ◽  
Sébastien Boissonneau ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Olfactory Nerve ◽  
Visual Field Defects ◽  
Tumor Control ◽  
Medial Side ◽  
Simpson Grade ◽  
Contralateral Approach ◽  
Tuberculum Sellae ◽  
Field Defects

Abstract Background: Most of tuberculum sellae meningiomas (TSM) show asymmetric growth. They are usually resected through ipsilateral approaches. The access of the inferior–medial side of the ipsilateral optic nerve might be challenging, which result in increased manipulation of the compromised optic nerve. The contralateral approach has been described to avoid these technical difficulties.Objective: Assessing the long term visual and olfactory outcome, as well as recurrence rate in patients operated for TSM through ipsi- or contralateral approaches.Methods: Single center retrospective cohort study about 94 patients operated on between March 2000 and April 2018.Results: 70% of the preoperative visual acuity loss totally resolved (44%) or showed varying degrees of improvement (26%) after surgery. Seventy-two percent of the preoperative visual field defects evolved favorably (44% recovery, 28% improvement). Eight patients showed aggravated visual disturbances (9%). A contralateral approach seemed to be predictive of visual field defects improvement after surgery (OR=0.4), with borderline significant results (p=.08). There was a higher rate of postoperative olfactory nerve impairment after a contralateral approach (37%vs17%, p=.03). Total removal of the tumor fragment entering the optic canal was accomplished in 96% in the contralateral vs 75% in the ipsilateral group (p=.04). The 2-, 5- & 7-year tumor progression free survival were 100% in the Simpson Grade 2 group, and 85% (n=17), 74% (n=11) & 67% (n=5) in the Simpson Grade 4 group, respectively (p=.00). Conclusion: Resection of tuberculum sellae meningiomas through a contralateral approach seems to provide better visual outcome and tumor control at the cost of increased olfactory nerve disorders.

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.

Radial Optic Neurotomy to Treat Patients with Visual Field Defects Associated with Optic Nerve Drusen

Retina ◽  
2011 ◽  
Vol 31 (3) ◽  
pp. 612-615 ◽  
Author(s):  
Martin M Nentwich ◽  
Matthias Remy ◽  
Christos Haritoglou ◽  
Anselm Kampik
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Visual Field Defects ◽  
Radial Optic Neurotomy ◽  
Field Defects ◽  
Optic Nerve Drusen

scholarly journals Local Relationship between Global-Flash Multifocal Electroretinogram Optic Nerve Head Components and Visual Field Defects in Patients with Glaucoma

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Chan Hee Moon ◽  
Jungwoo Han ◽  
Young-Hoon Ohn ◽  
Tae Kwann Park
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Nerve Head ◽  
Visual Field Defect ◽  
Multifocal Electroretinogram ◽  
Visual Field Defects ◽  
Global Flash ◽  
Field Defect ◽  
Normal Controls ◽  
Field Defects

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.

The Relationship Between Interocular Asymmetry of Visual Field Defects and Optic Nerve Head Blood Flow in Patients With Glaucoma

2019 ◽  
Vol 28 (3) ◽  
pp. 231-237
Author(s):  
Yutaro Yamada ◽  
Tomomi Higashide ◽  
Sachiko Udagawa ◽  
Satoshi Takeshima ◽  
Kimikazu Sakaguchi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Nerve Head ◽  
Visual Field Defects ◽  
The Relationship ◽  
Field Defects

A classic temporal optic disc pit showing progression in the corresponding optic nerve fiber and visual field defects

2012 ◽  
Vol 57 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Akihiko Tawara ◽  
Rie Miyamoto ◽  
Norihiko Tou ◽  
Shingo Ishibashi ◽  
Hiroyuki Kondo
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Nerve Fiber ◽  
Optic Disc ◽  
Visual Field Defects ◽  
Optic Disc Pit ◽  
Optic Nerve Fiber ◽  
Field Defects
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