Videopupillographic and VER Investigations in Patients with Congenital and Acquired Lesions of the Optic Radiation

Pupil campimetry in patients with visual field loss

“…It has to be differentiated if the underlying lesion involves retrogeniculate structures or the anterior visual pathway and herewith the traditional PLR arc. Several studies in the past have provided evidence for an impairment of pupil responses to small localized stimuli registered by pupillography also in patients with pure retrogeniculate damage (Bresky and Charles, 1969;Harms et al, 1973;Cibis et al, 1975;Hellner et al, 1978;Alexandridis et al, 1979;Hamann et al, 1979;Kardon, 1992). Our study confirms these findings in most of the patients.…”

The pupillary light reflex pathway

“…18 Many theories have been developed to explain these phenomena, the most prominent pointing out that the integrity of the pupillomotor response depends upon or is influenced also by the occipital cortex. [19][20][21][22] However, the anatomic evidence is still limited to make any clear conclusions.…”

“…18 Many theories have been developed to explain these phenomena, the most prominent pointing out that the integrity of the pupillomotor response depends upon or is influenced also by the occipital cortex. [19][20][21][22] However, the anatomic evidence is still limited to make any clear conclusions.The aims of this study thus were 1) to assess the presence and magnitude of the RAPD in patients with HVFDs due to cerebrovascular lesions in the posterior and middle cerebral artery territories, and 2) to analyze the association of the pupillary findings with the location and extent of the cerebral lesions. Further, the present study suggests 3) a new strategy of lesion analysis by combining established techniques with the stereotaxic probabilistic cytoarchitectonic atlas developed by the Jü lich group.…”

How sensitive is pupil campimetry in hemifield loss?

“…Studies in patients with retrogeniculate damage have provided good evidence for an impairment of pupil responses to small localized stimuli registered by pupillography [4][5][6][7][8][9][10][11][12][13]. Early clinical reports [4][5][6][7] were later reproduced by other groups using modern pupillometric techniques in patients well-documented by magnetic resonance imaging or computed tomography [8][9][10][11][12][13], and currently there is no doubt that the retrogeniculate visual pathway or even visual cortex is involved in the pupillary light reaction, and our results support those findings. Astonishingly, in our study the retrogeniculate lesions could be better reproduced than pregeniculate by pupil perimetry.…”

“…However, many reports in the literature [4][5][6][7][8][9][10][11][12][13] provide strong evidence that patients with isolated occipital lesions and homonymous visual field defects show corresponding pupil defects to focal light presented to the same area. The published findings provide compelling evidence for a role of cortical processing of the pupillary light reflex under certain stimulus conditions.…”