A free and simple computerized screening test for visual field defects

Nordfang, Maria; Uhre, Valdemar; Robotham, Ro Julia; Kerry, Sally; Frederiksen, Jette Lautrup; Starrfelt, Randi

doi:10.1111/sjop.12546

Cited by 7 publications

(4 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The laterality subgroups were not selected to be matched across demographic variables, but were not significantly different in terms of age, education level or time since stroke (all p’ s>0.1, see supplementary Table 1 for details). All patients underwent visual field (a.m. Nordfang et al 26 and visual acuity testing. 27 Visual field defects were found in 60 patients (94%).…”

Section: Methodsmentioning

confidence: 99%

Systematic evaluation of high level visual deficits and lesions in posterior cerebral artery stroke

Robotham

Rice

Leff

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Knowledge about the consequences of stroke on high level vision comes primarily from single case studies of patients selected based on their behavioural profiles with deficits in the recognition of a specific visual category such as faces or words. There are, however, no systematic, detailed, large-scale evaluations of the more typical clinical behavioural and lesion profiles of impairments in high level vision that may follow posterior cerebral artery (PCA) stroke. These goals were met by the current study through the data collected in the Back of the Brain (BoB) project: to date, the largest (N=64) and most detailed examination of patients with cortical PCA strokes selected based on lesion location rather than behavioural symptoms.We present here two complementary analyses of the structural neuroimaging data and key indices of behavioural performance with the visual processing words, objects and faces: (1) a multivariate multiple regression analysis to establish the relationships between lesion volume, lesion laterality or the presence of a bilateral lesion with performance on words, objects and faces; and, (2) a voxel-based correlational method (VBCM) analysis to establish whether there are distinct or separate regions within the PCA territory that underpin the visual processing of these categories.In contrast to the characterization of specific stroke syndromes like pure alexia or prosopagnosia in the literature, most patients in our cohort showed more general deficits in high level vision (n=22) or no deficits at all (n=21). Category-selective deficits were rare (n=6), and were only found for words, which, interestingly could follow left or right hemisphere lesions. The lesion analyses mainly confirmed the pattern reported in more selective cases: word recognition impairments are associated with a left-sided pattern of damage and face recognition deficits with a bilateral albeit right-dominant lesion pattern. Importantly, however, both general and more selective impairment may follow from left or right unilateral as well as bilateral lesions.While the findings provide partial support for the relative laterality of posterior brain regions supporting reading in the left and, to a lesser extent, face processing in the right hemisphere, the results suggest that both hemispheres are involved in the visual processing of faces, words and objects. This has ramifications for researchers studying the healthy brain and for clinicians working with patients with PCA stroke. Clinicians are recommended to carry out formal assessment of face, word and object recognition as most patients are expected to present with a mixed picture of deficits.

show abstract

Section: Methodsmentioning

confidence: 99%

Systematic evaluation of high level visual deficits and lesions in posterior cerebral artery stroke

Robotham

Rice

Leff

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…About the test: The computerized Visual Field Screening Test (c-VFT) is a freely available screening tool (running in PsychoPy) that was developed at the Department of Psychology at University of Copenhagen (Nordfang et al, 2019). Commonly used perimetry tests are time consuming and can be difficult to run on patients with mobility limitations.…”

Section: Computerised Visual Field Testmentioning

confidence: 99%

“…Integrity of visual field along the horizontal meridian is particularly relevant for reading. The c-VFT has been validated against the Esterman test and the Humphrey Visual Field Analyzer (HFA), central 10-2 that are perimetry tests commonly used in clinical settings (Nordfang et al, 2019).…”

Section: Computerised Visual Field Testmentioning

confidence: 99%

Behavioural test battery for the Back of the Brain project

Robotham¹,

Kerry²,

Rice³

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Much of the patient literature on the visual recognition of faces, words and objects is based on single case studies of patients selected according to their symptom profile. The Back of the Brain project aims to provide novel insights into the cerebral and cortical architecture underlying visual recognition of complex stimuli by adopting a different approach. A large group of patients was recruited according to their lesion location (in the areas supplied by the posterior cerebral artery) rather than their symptomatology. All patients were assessed with the same battery of sensitive tests of visual perception enabling the identification of dissociations as well as associations between deficits in face, word and object recognition. This paper provides a detailed description of the extensive behavioural test battery that was developed for the Back of the Brain project and that enables assessment of low-level, intermediate and high-level visual perceptual abilities. •Extensive behavioural test battery for assessing low-level, intermediate and high-level visual perception in patients with posterior cerebral artery stroke •Method enabling direct comparison of visual face, word and object processing abilities in patients with posterior cerebral artery stroke

show abstract

“…Confrontation continues to be used for bedside screening of stroke patients due to the difficulty of applying commercial visual field devices that require a degree of patient mobility and head/face coordination for testing ( 28 ). As a consequence, the nature of acquired visual field deficit in the acute phase of stroke (<72 h) has not been evaluated rigorously to date, though the advent of modern technology, and in particular tablet devices, afford ideal interfaces and test platforms for the testing of vision in hospitalized patients by their bedside ( 26 , 29 ). A newly developed iPad tablet application for measuring visual field integrity known as Melbourne Rapid Field-Neural (MRFn) has recently been validated against the gold standard Humphrey Visual Field Analyzer ( 30 ) making it an useful tool to measure the integrity of functional vision across the visual fields of both eyes in hospitalized patients.…”

Section: Introductionmentioning

confidence: 99%

Acquired Visual Deficits Independent of Lesion Site in Acute Stroke

2020

View full text Add to dashboard Cite

Most clinical diagnoses of stroke are based on the persistence of symptoms relating to consciousness, language, visual-field loss, extraocular movement, neglect (visual), motor strength, and sensory loss following acute cerebral infarction. Yet despite the fact that most motor actions and cognition are driven by vision, functional vision per se is seldom tested rigorously during hospitalization. Hence we set out to determine the effects of acute stroke on functional vision, using an iPad application (Melbourne Rapid Field-Neural) that can be used to assess vision (visual acuity and visual field sensitivity) at the bedside or in the emergency ward in about 6 min per eye. Our convenience sample comprised 60 (29-88 years, 65 ± 14 years, 33 males) of 160 sequentially presenting first episode, acute (<7 days) ischemic stroke patients at Sunshine Hospital, Melbourne. One hundred patients were excluded due to existing eye disease, inadequate radiological confirmation, inability to comply with English directions or too ill to participate. Stroke cases were compared with 37 (29-85 years, 64 ± 12 years,14 males) similaraged controls using a Mann-Whitney U-test. A significant loss in visual field sensitivity was measured in 68% of stroke cases (41/60, Mean Deviation: Stroke: −5.39 ± 6.26 dB, Control: 0.30 ± 0.60 dB, MWU = 246, p < 0.0001). Surprisingly, 44% (18/41) of these patients were unaware of their field loss. Although high contrast visual acuity was unaffected in most (55/60) patients, visual acuity-in-noise was reduced in 62% (37/60, Stroke: mean 6/12−2, log MAR 0.34 ± 0.21 vs. Control: mean 6/7•5-2, log MAR 0.14 ± 0.10; MWU = 470, p < 0.0001). Visual field defects were associated with all occipital, parietal and posterior cerebellar artery strokes while 9/15 middle cerebral artery lesions and 11 lesions in other brain regions were also associated with visual field defects. Our findings demonstrate that ∼2/3 of acute first episode ischemic stroke patients experience acquired vision deficits, often unrelated to the confirmed lesion site. Our results also imply that visual dysfunction may be associated with a more generalized cerebral dysfunction while highlighting the need for bedside testing of vision for every stroke patient and demonstrating the translational clinical value of the "Melbourne Rapid Field-Neural" iPad application.

show abstract

A free and simple computerized screening test for visual field defects

Cited by 7 publications

References 14 publications

Systematic evaluation of high level visual deficits and lesions in posterior cerebral artery stroke

Systematic evaluation of high level visual deficits and lesions in posterior cerebral artery stroke

Behavioural test battery for the Back of the Brain project

Acquired Visual Deficits Independent of Lesion Site in Acute Stroke

Contact Info

Product

Resources

About