Correlation of CAT scan and visual field defects in vascular lesions of the posterior visual pathways.

McAuley, David; Russell, Richard A.

doi:10.1136/jnnp.42.4.298

Cited by 65 publications

(23 citation statements)

References 15 publications

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“…4-6, 36, 37 Other associations consistent with clinical expectations include: AT7 (central scotoma) and AT13 (diffuse inferior defect) and worse BCVA, consistent with the involvement of central fixation in both of these VF ATs; AT12 (temporal hemianopia) and history of stroke -the lack of an association between AT15 (nasal hemianopia) and history of stroke may be in part due to the smaller sample size of patients with AT15 (nasal hemianopia) in this study cohort; and the trend toward an association between AT11 (peripheral rim defect) and VF trial lens spherical equivalent refractive error >6D (previously reported to cause lens rim artifact). 22,38,39 The female predominance among patients with AT16 (inferior paracentral defect) in our study cohort is consistent with estrogen's known role in modulating endothelial nitric oxide synthase POAG diagnosis and eight genes, three of which were specifically associated with early isolated paracentral VF loss and encode proteins that interact with eNOS. 6 In contrast, none of the eight genes was associated specifically with early isolated peripheral VF loss.…”

Section: Section 32 Visual Field Characteristicssupporting

confidence: 83%

Clinical Correlates of Computationally Derived Visual Field Defect Archetypes in Patients from a Glaucoma Clinic

Cai

Elze

Bex

et al. 2016

Current Eye Research

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Purpose: To assess the clinical validity of visual field (VF) archetypal analysis, a previously developed machine learning method for decomposing any Humphrey VF (24‒2) into a weighted sum of clinically recognizable VF loss patterns. Materials and Methods: For each of 16 previously identified VF loss patterns (“archetypes,” denoted AT1 through AT16), we screened 30,995 reliable VFs to select 10–20 representative patients whose VFs had the highest decomposition coefficients for each archetype. VF global indices and patient ocular and demographic features were extracted retrospectively. Based on resemblances between VF archetypes and clinically observed VF patterns, hypotheses were generated for associations between certain VF archetypes and clinical features, such as an association between AT6 (central island, representing severe VF loss) and large cup-to-disk ratio (CDR). Distributions of the selected clinical features were compared between representative eyes of certain archetypes and all other eyes using the two-tailed t-test or Fisher exact test. Results: 243 eyes from 243 patients were included, representative of AT1 through AT16. CDR was more often ≥ 0.7 among eyes representative of AT6 (central island; p = 0.002), AT10 (inferior arcuate defect; p = 0.048), AT14 (superior paracentral defect; p = 0.016), and AT16 (inferior paracentral defect; p = 0.016) than other eyes. CDR was more often < 0.7 among eyes representative of AT1 (no focal defect; p < 0.001) and AT2 (superior defect; p = 0.027), which was also associated with ptosis (p < 0.001). AT12 (temporal hemianopia) was associated with history of stroke (p = 0.022). AT11 (concentric peripheral defect) trended toward association with trial lens correction > 6D (p = 0.069). Conclusions: Shared clinical features between computationally derived VF archetypes and clinically observed VF patterns support the clinical validity of VF archetypal analysis.

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Section: Section 32 Visual Field Characteristicssupporting

confidence: 83%

Clinical Correlates of Computationally Derived Visual Field Defect Archetypes in Patients from a Glaucoma Clinic

Cai

Elze

Bex

et al. 2016

Current Eye Research

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“…2 In the 1990s, the Holmes map was revised by using MRI to correlate the region of primary visual cortex undergoing infarction with the respective visual field defects. 6,7 The basic findings in these studies demonstrated that, although largely accurate, the Holmes map had underestimated cortical magnification of central vision. Due to the nature of the striate cortex, with the majority of the visual field being represented on the hidden area within the calcarine sulcus, the revised maps depict the calcarine sulcus as if it had been flattened out.…”

Section: Discussionmentioning

confidence: 98%

“…13 This does not always lead to a complete homonymous hemianopia, as sparing of areas within the affected visual field can occur, the most common pattern of which is macular sparing. [6][7][8]13,14 There have been previous theories as to the reason for this, with bilateral representation of vision in both occipital lobes or artefacts of fixation proposed. 15 It seems likely, however, that sparing occurs due to incomplete damage to the calcarine cortex due to variations in the distribution of arterial supply to the calcarine cortex.…”

Section: Discussionmentioning

confidence: 99%

“…Early studies relied on correlating visual field plots against autopsy data or surface reference points in cases of survivors from shrapnel wounds. [1][2][3][4][5] There have been recent updates of the retinotopic map with data from computerised tomography (CT), 6 conventional magnetic resonance imaging (MRI) 7,8 in patients, and functional MRI (fMRI) in normal subjects. 9,10 The study of additional cases with unusual deficits can help in confirming our understanding of the retinotopic map.…”

Section: Introductionmentioning

confidence: 99%

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Bilateral Homonymous Hemianopia with Sparing of the Vertical Meridian

Panesar

Romanowski

Pepper

et al. 2011

Neuro-Ophthalmology

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A 19-year-old woman, who was 16 weeks post partum, collapsed with loss of consciousness. Following awakening she suffered abrupt loss of vision. Partial recovery occurred, although she has been left with bilateral homonymous hemianopia with sparing of vision just to the left of the vertical meridian. Magnetic resonance imaging demonstrated bilateral occipital infarcts, sparing the lips of the calcarine sulcus on the right. This is compatible with our expectation that the vertical meridian of the retinotopic map is represented at the superior and inferior lips of the calcarine sulcus.

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“…In this study, the lesion was 3,5 localized more anteriorly where the cortex is responsible for peripheral vision. Sparing of the occipital pole (by the haemorrhage) was responsible for macular sparing.…”

Section: Discussionmentioning

confidence: 99%

Homonymous Hemianopia with Macular Sparing: Clinical and Radiological Correlation - case presentation

Baisakhiya¹,

Agrawal²

2011

Nigerian Journal of Ophthalmology

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A classical case of homonymous hemianopia with macular sparing secondary to stroke involving the occipital cortex is presented. The lesion was localized more anteriorly where anatomically the peripheral vision function in the cerebral cortex is located. Sparing of the occipital pole was responsible for macular sparing in the patient. In this case there was good co-relation between clinical symptoms and radiological findings. This case highlights that well conducted visual field testing and careful evaluation of the visual field defect pattern can localize the lesion site approximately along the optic pathway that can be confirmed by modern imaging modalities.

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Correlation of CAT scan and visual field defects in vascular lesions of the posterior visual pathways.

Cited by 65 publications

References 15 publications

Clinical Correlates of Computationally Derived Visual Field Defect Archetypes in Patients from a Glaucoma Clinic

Clinical Correlates of Computationally Derived Visual Field Defect Archetypes in Patients from a Glaucoma Clinic

Bilateral Homonymous Hemianopia with Sparing of the Vertical Meridian

Homonymous Hemianopia with Macular Sparing: Clinical and Radiological Correlation - case presentation

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