Follow-up of visual field defects with vascular damage of the geniculostriate visual pathway

1987 ◽  
Vol 7 (4) ◽  
pp. 231-242 ◽  
Author(s):  
Birgitta Messing ◽  
Heinz Ganshirt
Keyword(s):  
Visual Field ◽  
Visual Pathway ◽  
Vascular Damage ◽  
Visual Field Defects ◽  
Field Defects

scholarly journals Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed

2011 ◽  
Vol 165 (1) ◽  
pp. 33-37 ◽  
Author(s):  
R Trifanescu ◽  
V Stavrinides ◽  
P Plaha ◽  
S Cudlip ◽  
J V Byrne ◽  
...  
Keyword(s):  
Visual Field ◽  
Visual Field Defects ◽  
Rathke's Cleft Cysts ◽  
Long Term Monitoring ◽  
Rathke's Cleft ◽  
Term Monitoring ◽  
Field Defects ◽  
Tsh Deficiency

ObjectiveTo clarify the outcome of all cases of Rathke's cleft cysts (RCC) treated surgically and followed up in Oxford during a long-term period.Subjects and methodsThe records of all patients with RCC seen in the Department of Endocrinology between January 1978 and June 2009 were reviewed.ResultsA total of 33 patients (20 females, median age 43 years) were identified. At presentation, major visual field defects were detected in 58% of patients and gonadotrophin, ACTH and TSH deficiency in 60, 36 and 36% of patients respectively. Desmopressin treatment was required in 18% of patients. Treatment consisted of cyst evacuation combined with or without biopsy/removal of the wall. Post-operatively, visual fields improved in 83% of patients with impairment, whereas there was no reversal of ACTH or TSH deficiency or of diabetes insipidus. All but one subject had imaging follow-up during a mean period of 48 months (range 2–267). Cyst relapse was detected in 22% of patients at a mean interval of 29 months (range 3–48 months); in 57% of them, the recurrence was symptomatic. Relapse-free rates were 88% at 24-months and 52% at 48-months follow-up. At last assessment, at least quadrantanopia was reported in 19% of patients, gonadotrophin, ACTH and TSH deficiency in 50, 42 and 47% of patients respectively. Desmopressin treatment was required in 39% of patients.ConclusionsIn this study of patients with RCC and long-term follow-up, we showed a considerable relapse rate necessitating long-term monitoring. Surgical intervention is of major importance for the restoration of visual field defects, but it does not improve endocrine morbidity, which in the long-term affects a substantial number of patients.

Neuro-ophthalmic effects of stenting across the ophthalmic artery origin in the treatment of intracranial aneurysms

2014 ◽  
Vol 121 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Robert S. Heller ◽  
Claire M. Lawlor ◽  
Thomas R. Hedges ◽  
Yanik J. Bababekov ◽  
Mina G. Safain ◽  
...  
Keyword(s):  
Visual Field ◽  
Intracranial Aneurysms ◽  
Ophthalmic Artery ◽  
Mass Effect ◽  
Visual Field Defects ◽  
Study Cohort ◽  
Visual Symptoms ◽  
Visual Complaints ◽  
Field Defects

Object The benefits of treating intracranial aneurysms in the region of the anterior visual pathways are well understood. However, the adverse effects of endovascular stenting across the ophthalmic artery have received little attention. The authors reviewed their experience with patients who had stents deployed across the ophthalmic artery origin. Methods Patients' medical charts and imaging studies were reviewed to identify all patients with a non–flow diverting stent deployed over the ophthalmic artery origin for the treatment of intracranial aneurysms. All patients with neuro-ophthalmic complaints were referred for formal ophthalmological evaluation. Results A total of 104 consecutive patients with 106 aneurysms were identified to meet criteria for inclusion in the study cohort. Preoperatively, 30 patients (29%) described headache symptoms and 32 patients (31%) reported visual complaints. Of the patients with preoperative headaches, 15 (54%) of 28 patients for whom follow-up was available experienced improvement in their symptoms. Of the patients with preoperative visual complaints, improvement was noted in 11 (41%) of the 27 patients for whom follow-up was available, 9 (33%) of 27 patients reported no change in visual symptoms, and 7 (26%) of 27 patients reported progression of symptoms. Visual field defects developing posttreatment were noted to occur in 8 (7.7%) of 104 patients: 3 with immediate postoperative retinal infarcts, 1 with perioperative hemianopia that resolved by the time of discharge, 1 with a subjective visual field defect, 1 with subjective migratory visual field defects, and 2 with nonspecific visual symptoms. Compressive symptoms from aneurysm mass effect were noted in 6 patients preoperatively, with 4 of those patients experiencing persistent worsening, resolution in 1 case, and no change in 1 case. One patient developed a novel cranial nerve palsy from mass effect in the immediate postoperative period. Conclusions Deployment of stents across the ophthalmic artery origin for the treatment of intracranial aneurysms appears to be relatively safe with regard to visual outcomes. Neuro-ophthalmic complaint resolution rates were comparable to endovascular procedures that do not employ stents, with headache resolution rates comparable to coil-only aneurysm obliteration and low rates of retinal ischemic events. For patients presenting with mass effect, stent-assisted coiling appears to be less effective than microsurgery with decompression for relief of compressive symptoms.

scholarly journals Monocular Visual Field Defect on Humphrey 24-2 SITA-Fast Testing Later Identified as a Highly Incongruous Homonymous Defect on Humphrey 30-2 SITA-Fast Testing

2021 ◽  
pp. 507-512
Author(s):  
Caberry W. Yu ◽  
Jonathan A. Micieli
Keyword(s):  
Visual Field ◽  
Visual Field Defect ◽  
Anterior Segment ◽  
Field Testing ◽  
Visual Pathway ◽  
Visual Field Defects ◽  
Inner Plexiform Layer ◽  
Visual Field Testing ◽  
Field Defect ◽  
Field Defects

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.

scholarly journals The Effects of Compensatory Scanning Training on Mobility in Patients with Homonymous Visual Field Defects: Further Support, Predictive Variables and Follow-Up

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0166310 ◽  
Author(s):  
Gera A. de Haan ◽  
Bart J. M. Melis-Dankers ◽  
Wiebo H. Brouwer ◽  
Oliver Tucha ◽  
Joost Heutink
Keyword(s):  
Visual Field ◽  
Visual Field Defects ◽  
Predictive Variables ◽  
Field Defects

scholarly journals The natural course of non-functioning pituitary macroadenomas

2007 ◽  
Vol 156 (2) ◽  
pp. 217-224 ◽  
Author(s):  
O M Dekkers ◽  
S Hammer ◽  
R J W de Keizer ◽  
F Roelfsema ◽  
P J Schutte ◽  
...  
Keyword(s):  
Visual Field ◽  
Tumor Growth ◽  
Transsphenoidal Surgery ◽  
Tumor Volume ◽  
Visual Fields ◽  
Visual Field Defects ◽  
Pituitary Insufficiency ◽  
Field Defects ◽  
Pituitary Macroadenomas

Objective: The natural history of non-functioning pituitary macroadenomas (NFMA) has not been completely elucidated. Therefore, we evaluated pituitary function, visual fields, and tumor size during long-term follow-up of non-operated patients with NFMA. Design: Follow-up study. Patients: Twenty-eight patients (age 55 ± 3 years) with NFMA, not operated after initial diagnosis, were included. Results: Initial presentation was pituitary insufficiency in 44%, visual field defects in 14%, apoplexy in 14%, and chronic headache in 7% of the patients. The duration of follow-up was 85 ± 13 months. Radiological evidence of tumor growth was observed in 14 out of 28 patients (50%) after duration of follow-up of 118 ± 24 months. Six patients (21%) were operated, because tumor growth was accompanied by visual field defects. Visual impairments improved in all the cases after transsphenoidal surgery. Spontaneous reduction in tumor volume was observed in eight patients (29%). No independent predictors for increase or decrease in tumor volume could be found by regression analysis. Conclusion: Observation alone is a safe alternative for transsphenoidal surgery in selected NFMA patients, without the risk of irreversibly compromising visual function.

scholarly journals A longitudinal observation of a patient with normal tension glaucoma

2017 ◽  
Vol 76 (1) ◽  
Author(s):  
Hlupheka L. Sithole
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Field Analysis ◽  
Visual Field Defects ◽  
Due Diligence ◽  
Longitudinal Observation ◽  
Eye Examination ◽  
Field Defects

Normal tension glaucoma (NTG) is a disease associated with normal intraocular pressure (10 mmHg – 21 mmHg) that may lead to irreversible blindness if misdiagnosed or left untreated over a period of time. The author observed a patient with NTG over a period of 5 years (from 2013 to 2017). The initial visual field analysis results (2014) showed mild visual field defects because of NTG at the start of the 5-year period. Although the patient was also diagnosed with hydrocephalus, a condition associated with optic nerve head damage, following years of noncompliance to treatment of NTG and follow-up eye examination schedules, the patient’s visual field defects were found to have progressed by the year 2017. It is therefore important for optometrists to apply due diligence when examining patients with NTG in order to expedite intervention and prevention of visual impairment and blindness.

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