Eyes and stroke: the visual aspects of cerebrovascular disease

Pula, John H.; Yuen, Carlen

doi:10.1136/svn-2017-000079

Cited by 90 publications

(62 citation statements)

References 51 publications

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“…Despite the reportedly good test-retest reliability of OCT und mfVEP (32-34) we cannot rule out sampling artifacts resulting from the relatively small sample size of our study. Another limitation is the inclusion of patients with different extensions of PCA infarctions identified by MRI or CT scans, which additionally might miss smaller lesions in other brain areas, especially in the case of CT. We therefore cannot completely rule out concomitant additional direct ischemic insults to the optic tract and LGN (35,36) beyond the infarctions identified. Such infarctions could have caused the observed retinal layer changes by direct retrograde axonal degeneration, rather than by TRD.…”

Section: Discussionmentioning

confidence: 92%

“…However, one would expect that these lesions would have occurred in a random distribution on both the ipsilateral and contralateral side of the PCA infarction rather than only on the ipsilateral side where we observed the degeneration in our study. In addition, patients with ischemic stroke may have a considerable risk of concomitant ischemic damage to the anterior visual pathways based on their vascular risk factors (36). However, as stated above, this would affect the anterior visual pathway of both eyes.…”

Section: Discussionmentioning

confidence: 99%

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Retinal Changes After Posterior Cerebral Artery Infarctions Display Different Patterns of the Nasal und Temporal Sector in a Case Series

et al. 2020

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Background: Visual field defects are a common and disabling consequence of stroke and a negative prognostic factor of patient's quality of life. They result from lesions in different parts of the visual system, most commonly the visual cortex and optic radiation. An important pathophysiological mechanism is transsynaptic retrograde degeneration (TRD). Methods: In a case series 21 patients with posterior cerebral artery (PCA) territory infarctions were analyzed by spectral-domain optical coherence tomography (SD-OCT) and multifocal visual evoked potentials (mfVEPs) cross-sectionally and longitudinally for up to 6 months. In OCT, symptomatic affected nasal and temporal sectors and corresponding visual fields in mfVEPs were compared to the contralateral side. Results: SD-OCT revealed a significant reduction (−2.92 ±2.53 µm, mean ± SD) of the symptomatic nasal macular retinal nerve fiber layer (RNFL) thickness and of the symptomatic temporal peripapillary RNFL after 6 months compared to baseline whereas the symptomatic temporal macular quadrant already showed a significantly thinner RNFL at baseline. The mfVEP first peak latency at baseline was significantly different (nasal visual field +11.69 ±11.17 ms, mean ± SD; temporal visual field +16.63 ±7.97 ms, mean ± SD) on the symptomatic compared to the asymptomatic field. The nasal visual fields partly recovered in amplitude and first peak latency of mfVEPs over the following 6 months compared to baseline. Conclusion: The dynamics of OCT and mfVEP outcomes for degeneration and recovery after PCA infarction differ between the nasal and temporal retinal sector. We postulate that retinal sectors may differ in their temporal pattern of TRD over time after retrogeniculate cerebral infarction.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Retinal Changes After Posterior Cerebral Artery Infarctions Display Different Patterns of the Nasal und Temporal Sector in a Case Series

et al. 2020

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“…Papilooedema may be present due to the brain oedema secondary to stroke. (21). Posterior pole hemorrhages (Terson syndrome) as a result of intracranial hemorrhages may be present (22).…”

Section: Causes Of Binocular Diplopiamentioning

confidence: 99%

Non-surgical correction of diplopia after stroke- a strong impact factor on quality of life-minireview

Nicula

Nicula²,

Bulboacă

2019

BALNEO

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One of the most frequent disorders accompanied by diplopia is represented by stroke. Beyond different symptoms of stroke, diplopia constitutes an important clinical factor in influencing the quality of life in surviving patients. In this paper we discuss the visual impairment associated with stroke location, types of diplopia, the clinical examination, and the nonsurgical treatment of diplopia. The purpose of diplopia treatment is to restore binocular vision and eliminate the double vision. The most used nonsurgical treatment for diplopia is the optical correction by the prisms. Another therapeutic option is the botulinum toxin injections. Key words: diplopia, stroke, visual rehabilitation, prism correction,

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“…Vascular diseases affecting the eye are multifactorial in origin, with many risk factors contributing to their onset. Systemic risk factors include nocturnal arterial hypotension, arterial hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, blood loss, atherosclerosis, sleep apnea syndrome, cardiovascular disorders, tobacco smoking, obesity, atrial fibrillation, hyperhomocysteinemia, varicose veins, and coagulation disorders (activated protein C resistance or factor V Leiden mutation), among others [3,[8][9][10][11]. Ocular risk factors include elevated intraocular pressure, glaucoma, a small and crowded disc, or optic disc drusen that can influence the optic nerve head blood supply [9,12].…”

Section: Introductionmentioning

confidence: 99%

The Use of Vitamins and Coenzyme Q10 for the Treatment of Vascular Occlusion Diseases Affecting the Retina

et al. 2020

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Nutritional supplementation with antioxidants and vitamins is widely recommended in the treatment of vascular disorders affecting the retina, although there is insufficient evidence on its effectiveness. The vitamin-like compound coenzyme Q10 (CoQ10) is a nutritional supplement of current interest to treat neurodegenerative diseases. Here, we report a retrospective clinical case series study of 48 patients diagnosed with retinal vascular diseases, including non-arteritic ischemic optic neuropathy (NAION), retinal artery occlusion (RAO), and homonymous hemianopia or quadrantanopia following stroke, treated with oral supplementation with CoQ10 (100 mg per day) and vitamins. Patient follow-up was performed using the Humphrey field analyzer and 30-2 testing algorithm to determine the visual field index (VFI) and progression rates. All treated patients showed positive VFI progression rates per year: +11.5 ± 15% for NAION patients (n = 18), +22 ± 17% for RAO patients (n = 7), +9.3 ± 10.5% for hemianopia/quadrantanopia patients (n = 10), and +11 ± 21% for patients with other conditions (n = 13). The interruption of CoQ10 supplementation in one patient resulted in a pronounced decrease of the VFI, which was partially recovered when treatment was restored. This study supports the role of CoQ10 as a nutritional therapeutic agent for vascular diseases affecting the retina. Owing to decreased VFI after interruption of CoQ10, its beneficial effects may be reversible.

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Eyes and stroke: the visual aspects of cerebrovascular disease

Cited by 90 publications

References 51 publications

Retinal Changes After Posterior Cerebral Artery Infarctions Display Different Patterns of the Nasal und Temporal Sector in a Case Series

Retinal Changes After Posterior Cerebral Artery Infarctions Display Different Patterns of the Nasal und Temporal Sector in a Case Series

Non-surgical correction of diplopia after stroke- a strong impact factor on quality of life-minireview

The Use of Vitamins and Coenzyme Q10 for the Treatment of Vascular Occlusion Diseases Affecting the Retina

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