Visual Field Profile of Optic Neuritis

Keltner, John L.

doi:10.1001/archophthalmol.2010.16

Cited by 81 publications

(15 citation statements)

References 28 publications

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“…Besides MS, blinding ONs are exceptional. They only represent 3.6% of observed ON throughout the course of MS, even course though 36.9% of patients show total vision loss at the acute phase 16. In Slamovits et al’s study, among 12 ON cases without light perception, eight recovered with a visual acuity superior to 20/40 and four with a visual acuity less than 20/40 but with periphery vision conservation.…”

Section: Discussionmentioning

confidence: 94%

Visual field characteristics in neuromyelitis optica in absence of and after one episode of optic neuritis

Merle¹,

Olindo²,

Jeannin³

et al. 2013

OPTH

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PurposeOptic neuritis (ON) observed during neuromyelitis optica (NMO) is in most cases very severe and with poor prognosis. This study’s objective was to analyze visual field (VF) abnormalities observed in the absence of ON and post-ON episode.MethodsTwenty-seven cases of both NMO and multiple sclerosis (MS) were selected. Thorough ophthalmologic exam was performed at least 6 months post-ON attack. The VF was collected using the Humphrey 750 perimeter. We used the central threshold tests 24-2 with FASTPAC strategy. The abnormalities were categorized based on the Optic Neuritis Treatment Trial classification.ResultsAfter one ON, 40% of the NMO group’s eyes showed total VF loss (P = 0.01), 21% showed abnormalities of neurologic aspect, and 27% showed fascicular abnormalities of which 12% were altitudinal. Given the total VF loss, the positive predictive value in favor of an NMO was 92.8% and the negative predictive value was 47.3%.ConclusionAlterations of the VF during the NMO differ from those observed in the course of the MS. One ON, blinding from the first attack, must call to mind an NMO. The altitudinal deficits point to a vascular mechanism.

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Section: Discussionmentioning

confidence: 94%

Visual field characteristics in neuromyelitis optica in absence of and after one episode of optic neuritis

Merle¹,

Olindo²,

Jeannin³

et al. 2013

OPTH

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“…For classification, we have refined the methodology from previous UC Davis Visual Field Reading Center (VFRC) studies. 11 – 14 The classification system of the IIHTT contained six categories (enlarged blind spot, generalized depression, arcuate nerve fiber bundle, neurologic-like/other, central and normal). The categories were subdivided into more specific classes as shown in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

Visual Field Outcomes for the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT)

Wall

Johnson

Cello

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PurposeThe Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) showed that acetazolamide provided a modest, significant improvement in mean deviation (MD). Here, we further analyze visual field changes over the 6-month study period.MethodsOf 165 subjects with mild visual loss in the IIHTT, 125 had perimetry at baseline and 6 months. We evaluated pointwise linear regression of visual sensitivity versus time to classify test locations in the worst MD (study) eye as improving or not; pointwise changes from baseline to month 6 in decibels; and clinical consensus of change from baseline to 6 months.ResultsThe average study eye had 36 of 52 test locations with improving sensitivity over 6 months using pointwise linear regression, but differences between the acetazolamide and placebo groups were not significant. Pointwise results mostly improved in both treatment groups with the magnitude of the mean change within groups greatest and statistically significant around the blind spot and the nasal area, especially in the acetazolamide group. The consensus classification of visual field change from baseline to 6 months in the study eye yielded percentages (acetazolamide, placebo) of 7.2% and 17.5% worse, 35.1% and 31.7% with no change, and 56.1% and 50.8% improved; group differences were not statistically significant.ConclusionsIn the IIHTT, compared to the placebo group, the acetazolamide group had a significant pointwise improvement in visual field function, particularly in the nasal and pericecal areas; the latter is likely due to reduction in blind spot size related to improvement in papilledema. (ClinicalTrials.gov number, NCT01003639.)

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“…Reduction in contrast sensitivity was associated with reduced vision-related quality of life ( Cole et al , 2000 ) and provided the rationale for considering assessment of low-contrast vision as a sensitive visual outcome in multiple sclerosis clinical trials. Another key outcome measure in the Optic Neuritis Treatment Trial was automated (Humphrey) visual field testing ( Keltner et al , 1994 , 2010 ). This quantitative method remains an important aspect of visual assessment of optic neuritis and other neuro-ophthalmological disorders affecting the optic nerve.…”

Section: Visual Outcomes In Optic Neuritis and Multiple Sclerosis CLImentioning

confidence: 99%

Vision and vision-related outcome measures in multiple sclerosis

Balcer

Miller

Reingold³

et al. 2014

Brain

180

175

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Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes assessment in clinical practice and therapeutic trials in multiple sclerosis.

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Visual Field Profile of Optic Neuritis

Cited by 81 publications

References 28 publications

Visual field characteristics in neuromyelitis optica in absence of and after one episode of optic neuritis

Visual field characteristics in neuromyelitis optica in absence of and after one episode of optic neuritis

Visual Field Outcomes for the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT)

Vision and vision-related outcome measures in multiple sclerosis

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