Evaluation of visual field defects in neuro- ophthalmology

Abstract

Aim: The aim of the study is to evaluate the visual field defects in neuro-ophththamology and in patients with lesions involving the visual pathway. Introduction: Visual field testing is done with Standard automated perimetry. This helps in the early diagnosis of visual field defects in brain tumours, localization, differential diagnosis, monitoring progression and recurrences and helps in diagnosing hidden visual loss. Materials and Methods: 100 cases were included in the study. These cases had intracranial tumours, pituitary tumours and pailloedema. All the cases were referred for visual fields examination from neurology and neurosurgery departments. Standard automated perimetry was done in all cases. Results: Out of 100 cases, 31 cases had pituitary tumours, 33 patients had papilloedema and 36 patients had other intracranial tumours. Normal visual fields were noted in 36 cases and visual field defects were noted in 64 cases. Bitemporal hemianopia was noted in 18 cases, homonymous hemianopia in 16 cases, enlargement of blind spot in 15 cases, generalized constriction of fields in 5 cases, quadrantinopia in 6 cases and field defects involving three quadrants was noted in 4 cases. Conclusion: Complete Ophthalmological examination including perimetry should be done in patients with intracranial tumors involving visual pathway. Some patients are visually asymptomatic even when they have visual field defects. Automated perimetry is the most sensitive and specific for diagnosing the visual field defects in neuro-ophthalmology cases. Perimetry is useful in localizing the tumors and should be repeated after surgery to monitor for resolution or recurrence. Patients with visual field defects have difficulty in doing their daily activities and affect the quality of life. Rehabilitation should be considered in these cases. Keywords: Bitemporal hemianopia, Homonymous hemianopia, Papilloedema, Pituitary tumors, Visual field defects.