scholarly journals Peripapillary Retinal Thickness Maps in the Evaluation of Glaucoma Patients: A Novel Concept

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Kayoung Yi ◽  
Mircea Mujat ◽  
Wei Sun ◽  
B. Hyle Park ◽  
Johannes F. de Boer ◽  
...  
Keyword(s):  
Visual Field ◽  
Retinal Thickness ◽  
Field Testing ◽  
Fundus Photography ◽  
Visual Field Defects ◽  
Visual Field Testing ◽  
Fiber Layer ◽  
Rnfl Thickness ◽  
Novel Concept ◽  
Field Defects

Purpose. To show how peripapillary spectral domain optical coherence tomography (SDOCT) retinal thickness (RT) maps can complement retinal nerve fiber layer (RNFL) thickness maps in the evaluation of glaucoma patients. Methods. After a complete eye exam with standard fundus photography and visual field testing, normal and glaucomatous eyes were imaged with an experimental SDOCT system. From SDOCT images, RNFL thickness and RT maps were constructed and then correlated with disc photography and visual field testing. Results. Two normal eyes of 2 patients and 5 eyes of 4 glaucoma patients were imaged. Although both RNFL and RT maps correlated well with visual field defects, glaucomatous arcuate defects were sometimes more easily identified in the RT maps. Conclusions. To our knowledge, this is the first paper to show that peripapillary SDOCT RT maps may provide important supplemental information to RNFL thickness maps in the evaluation of glaucoma patients.

Morphology of the optic nerve head in glaucomatous eyes with visual field defects in superior or inferior hemifield

2017 ◽  
Vol 28 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Antonio Longo ◽  
Teresio Avitabile ◽  
Maurizio G. Uva ◽  
Vincenza Bonfiglio ◽  
Andrea Russo ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Optic Nerve Head ◽  
Field Testing ◽  
Visual Field Defects ◽  
Fiber Layer ◽  
Rnfl Thickness ◽  
Pattern Deviation ◽  
Control Study ◽  
Field Defects

Purpose: To evaluate the morphology of optic nerve head (ONH) and border tissue (BT) of Elschnig in glaucomatous eyes with visual field defects in superior or inferior hemifield. Methods: In a case-control study, we included 25 patients with superior arcuate scotoma, 25 patients with inferior arcuate scotoma, and 25 healthy controls. They received visual field testing, measurement of peripapillary retinal nerve fiber layer (RNFL) thickness, and ONH examination in a radial pattern with spectral-domain optical coherence tomography. In each ONH scan, the length of Bruch membrane opening (BMO) and BT were measured. Pattern deviation of 6 areas of the visual field and RNFL thickness in corresponding sectors was calculated. Results: Mean BMO length did not differ between groups. Compared with controls, glaucomatous eyes with superior scotoma had a greater BT length in inferior sectors (p<0.001), and eyes with inferior scotoma had a greater BT length in superotemporal sectors (p = 0.006). In both groups, a significant correlation was found between BT length and pattern deviation and RNFL thickness of corresponding sectors of superior and inferior hemifields. Conclusions: In patients with arcuate scotoma in one hemifield, the length of the BT correlates with glaucomatous anatomical and functional damage.

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.

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.

Early hydroxychloroquine retinopathy: optical coherence tomography abnormalities preceding Humphrey visual field defects

2019 ◽  
Vol 103 (11) ◽  
pp. 1600-1604 ◽  
Author(s):  
Sean T Garrity ◽  
Joo Yeon Jung ◽  
Olivia Zambrowski ◽  
Francesco Pichi ◽  
Daniel Su ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Vision Loss ◽  
Tertiary Care ◽  
Fundus Photography ◽  
Visual Field Defects ◽  
Optical Coherence ◽  
Humphrey Visual Field ◽  
Hydroxychloroquine Retinopathy ◽  
Field Defects

Background/AimsHydroxychloroquine (HCQ) retinopathy may result in severe and irreversible vision loss, emphasising the importance of screening and early detection. The purpose of this study is to report the novel finding of early optical coherence tomography (OCT) abnormalities due to HCQ toxicity that may develop in the setting of normal Humphrey visual field (HVF) testing.MethodsData from patients with chronic HCQ exposure was obtained from seven tertiary care retina centres. Ten patients with HCQ-associated OCT abnormalities and normal HVF testing were identified. Detailed analysis of the OCT findings and ancillary tests including colour fundus photography, fundus autofluorescence, multifocal electroretinography and microperimetry was performed in these patients.ResultsSeventeen eyes from 10 patients illustrated abnormalities with OCT and normal HVF testing. These OCT alterations included (1) attenuation of the parafoveal ellipsoid zone and (2) loss of a clear continuous interdigitation zone. Several eyes progressed to advanced parafoveal outer retinal disruption and/or paracentral visual field defects.ConclusionPatients with high risk HCQ exposure and normal HVF testing may develop subtle but characteristic OCT abnormalities. This novel finding indicates that, in some cases of early HCQ toxicity, structural alterations may precede functional impairment. It is therefore important to employ a screening approach that includes OCT to assess for these early findings. Ancillary testing should be considered in cases with suspicious OCT changes and normal HVFs.

Does Nerve Fiber Layer Thickness Correlate with Visual Field Defects in Glaucoma?

1997 ◽  
Vol 211 (6) ◽  
pp. 338-340 ◽  
Author(s):  
M. Marraffa ◽  
C. Mansoldo ◽  
R. Morbio ◽  
R. De Natale ◽  
L. Tomazzoli ◽  
...  
Keyword(s):  
Visual Field ◽  
Nerve Fiber ◽  
Layer Thickness ◽  
Visual Field Defects ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Nerve Fiber Layer Thickness ◽  
Field Defects

scholarly journals Topographic correlation and asymmetry analysis of ganglion cell layer thinning and the retinal nerve fiber layer with localized visual field defects

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0222347 ◽  
Author(s):  
Alfonso Casado ◽  
Andrea Cerveró ◽  
Alicia López-de-Eguileta ◽  
Raúl Fernández ◽  
Soraya Fonseca ◽  
...  
Keyword(s):  
Visual Field ◽  
Ganglion Cell ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Ganglion Cell Layer ◽  
Cell Layer ◽  
Visual Field Defects ◽  
Fiber Layer ◽  
Asymmetry Analysis ◽  
Field Defects

Retrogeniculate Visual Field Defects

Visual Fields ◽  
2010 ◽  
Author(s):  
Thomas R. Hedges III
Keyword(s):  
Visual Field ◽  
Vision Loss ◽  
Visual Fields ◽  
Field Testing ◽  
Visual Field Defects ◽  
Automated Perimetry ◽  
Loss Of Vision ◽  
Data Points ◽  
Field Defects ◽  
Macular Sparing

Automated perimetry has changed visual field testing considerably in recent years. What was considered an art has become an exercise in interpreting a set of data points obtained mechanically. Automated perimetry saves ophthalmologists time, which ideally should allow for more visual fields to be obtained on patients with unexplained vision loss. However, one must still keep in mind that automated perimetry still depends on the subjective responses from the patient. More important, automated perimetry has made interpretation of visual field defects, especially those due to occipital lesions, more difficult. For example, macular sparing may not be reflected, especially with programs limited to the central 24° or 30°. A 10° field may be required to show macular sparing. Also, sparing or involvement of the temporal crescent will not be shown with 24° or 30° visual fields. The limitation of most programs may lead to the appearance of incongruity when in fact the field is indeed congruous. Sometimes, a small homonymous hemianopic scotoma will be detected when one eye is tested but will be completely missed when the other eye is tested, giving the false impression that the visual loss is monocular. This is especially problematic if the patient also falsely interprets his or her homonymous loss of vision as monocular. Such individuals may complain of loss of vision in one eye when in fact it is one half of their visual field that is defective. The strategy of automated testing on either side the vertical and horizontal meridians may lead to the false impression that field defects respect the vertical or horizontal meridian when they do not. Automated perimetry should make it possible to test more patients with unexplained vision loss, but all automated visual fields must be interpreted with caution and, when necessary, substantiated with some other method, such as the tangent screen, which remains the most powerful method of detecting the size, shape, and density of visual field defects. Because most ophthalmologists no longer use tangent screen testing, at least an Amlser grid should be used to qualify the nature of a paracentral visual field defect.

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