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Visual fields in neuro-ophthalmology.

Kedar S, Ghate D, Corbett JJ - Indian J Ophthalmol (2011 Mar-Apr)

Bottom Line: Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up.They are used as screening tools for toxic optic neuropathy from medications such as ethambutol and vigabatrin.Visual field testing must be performed in all patients with lesions of the visual pathway.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA. drsachinkedar@gmail.com

ABSTRACT
Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up. Standard automated perimetry has been shown to be adequate in neuro-ophthalmic practise and is now the technique of choice for a majority of practitioners. Goldman kinetic visual fields are useful for patients with severe visual and neurologic deficits and patients with peripheral visual field defects. Visual fields are useful in monitoring progression or recurrence of disease and guide treatment for conditions such as idiopathic intracranial hypertension (IIH), optic neuropathy from multiple sclerosis, pituitary adenomas, and other sellar lesions. They are used as screening tools for toxic optic neuropathy from medications such as ethambutol and vigabatrin. Visual field defects can adversely affect activities of daily living such as personal hygiene, reading, and driving and should be taken into consideration when planning rehabilitation strategies. Visual field testing must be performed in all patients with lesions of the visual pathway.

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Visual field defects in idiopathic intracranial hypertension. (a) Enlarged blind spot. (b) Nasal step. (c) Biarcuate scotoma. (d) Severe visual field constriction
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Figure 0002: Visual field defects in idiopathic intracranial hypertension. (a) Enlarged blind spot. (b) Nasal step. (c) Biarcuate scotoma. (d) Severe visual field constriction

Mentions: Papilledema refers to the swelling of the optic nerve head secondary to raised cerebrospinal fluid (CSF) pressure. IIH is defined as raised intracranial pressure (ICP) in the absence of radiologic and laboratory abnormalities reflecting any other known cause of raised ICP.[15] Vision loss is the most feared complication of IIH with at least 10% of patients progressing to blindness from IIH.[16] The visual field defects that result from papilledema in IIH are “disc-related defects” and are similar to those found in glaucoma.[17] Visual field losses may be identified in as many as 96% of patients using disease-specific perimetric strategies such as the Armaly-Drance strategy for Goldmann perimetry or SAP. The most common defects seen in IIH are blind spot enlargement, generalized constriction, and loss of the nasal visual fields, especially inferonasal [Fig. 2].[18] Other common field defects described include inferior altitudinal loss, superonasal and superotemporal loss,[19] arcuate defects, and scotomas (central, cecocentral, and paracentral).[20] The commonly used visual field strategies such as full threshold and SITA standard were found to be comparable in the detection of visual field loss on individual examinations.[21] Patients with IIH should be followed with sequential quantitative perimetry to aid rational decision making and prevent vision loss. The same visual field testing strategy should be used at each visit to obtain comparable data in follow-up.


Visual fields in neuro-ophthalmology.

Kedar S, Ghate D, Corbett JJ - Indian J Ophthalmol (2011 Mar-Apr)

Visual field defects in idiopathic intracranial hypertension. (a) Enlarged blind spot. (b) Nasal step. (c) Biarcuate scotoma. (d) Severe visual field constriction
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3116538&req=5

Figure 0002: Visual field defects in idiopathic intracranial hypertension. (a) Enlarged blind spot. (b) Nasal step. (c) Biarcuate scotoma. (d) Severe visual field constriction
Mentions: Papilledema refers to the swelling of the optic nerve head secondary to raised cerebrospinal fluid (CSF) pressure. IIH is defined as raised intracranial pressure (ICP) in the absence of radiologic and laboratory abnormalities reflecting any other known cause of raised ICP.[15] Vision loss is the most feared complication of IIH with at least 10% of patients progressing to blindness from IIH.[16] The visual field defects that result from papilledema in IIH are “disc-related defects” and are similar to those found in glaucoma.[17] Visual field losses may be identified in as many as 96% of patients using disease-specific perimetric strategies such as the Armaly-Drance strategy for Goldmann perimetry or SAP. The most common defects seen in IIH are blind spot enlargement, generalized constriction, and loss of the nasal visual fields, especially inferonasal [Fig. 2].[18] Other common field defects described include inferior altitudinal loss, superonasal and superotemporal loss,[19] arcuate defects, and scotomas (central, cecocentral, and paracentral).[20] The commonly used visual field strategies such as full threshold and SITA standard were found to be comparable in the detection of visual field loss on individual examinations.[21] Patients with IIH should be followed with sequential quantitative perimetry to aid rational decision making and prevent vision loss. The same visual field testing strategy should be used at each visit to obtain comparable data in follow-up.

Bottom Line: Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up.They are used as screening tools for toxic optic neuropathy from medications such as ethambutol and vigabatrin.Visual field testing must be performed in all patients with lesions of the visual pathway.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA. drsachinkedar@gmail.com

ABSTRACT
Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up. Standard automated perimetry has been shown to be adequate in neuro-ophthalmic practise and is now the technique of choice for a majority of practitioners. Goldman kinetic visual fields are useful for patients with severe visual and neurologic deficits and patients with peripheral visual field defects. Visual fields are useful in monitoring progression or recurrence of disease and guide treatment for conditions such as idiopathic intracranial hypertension (IIH), optic neuropathy from multiple sclerosis, pituitary adenomas, and other sellar lesions. They are used as screening tools for toxic optic neuropathy from medications such as ethambutol and vigabatrin. Visual field defects can adversely affect activities of daily living such as personal hygiene, reading, and driving and should be taken into consideration when planning rehabilitation strategies. Visual field testing must be performed in all patients with lesions of the visual pathway.

Show MeSH
Related in: MedlinePlus