Functional Visual Fields Research Articles

Vision-related quality of life in patients with glaucoma before and after trabeculectomy.

To determine vision-related quality of life (VR-QoL) and functional and structural parameters associated with VR-QoL in patients with glaucoma before and 12 months after trabeculectomy. Fifty-eight patients undergoing trabeculectomy were included. Participants completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) prior to and 12 months after trabeculectomy. Functional (visual acuity and visual fields) and structural (ganglion cell layer volume) parameters were evaluated for their association with VR-QoL using multiple linear regression of VFQ-25 subscale scores. Intraocular pressure and the number of glaucoma medications were also included in the analyses. The VFQ-25 composite score did not change after trabeculectomy (before: 74.9; 12 months: 74.0; p = 0.512). The subscale mental health had a significantly higher score 12 months after trabeculectomy (before: 65.6; 12 months: 71.4; p = 0.017). The VFQ-25 scores for general health (before: 68.5; 12 months: 62.5; p = 0.009) and role difficulties (before: 78.9; 12 months: 53.7; p < 0.001) were significantly lower 12 months after trabeculectomy. No functional or structural parameters were associated with VFQ-25 composite score. Overall, VR-QoL in glaucoma patients was similar before and after trabeculectomy, reflecting the procedure's stabilizing effect on both objective and subjective visual function. The absence of correlations between VR-QoL and clinical parameters emphasizes the multifaceted nature of VR-QoL and highlights the limitations of depending solely on objective clinical metrics to evaluate patients' subjective experiences. Using both objective measures and VR-QoL, clinicians can better understand the challenges patients face due to glaucoma and trabeculectomy, potentially leading to better solutions.

Multiple Functional Visual Fields (FVFs) surround the same fixation point during visual search

Multiple Functional Visual Fields (FVFs) surround the same fixation point during visual search

Guided Search 6.0: An upgrade with five forms of guidance, three types of functional visual fields, and two, distinct search templates

Guided Search 6.0: An upgrade with five forms of guidance, three types of functional visual fields, and two, distinct search templates

Clinical Research of the Remanent Diplopia Correction Operation After Orbital Fracture Repair.

To investigate the occasion, method and effectiveness of the diplopic correction after the orbital fracture repair in Chinese patients with orbital fracture. This was a retrospective observational study of 64 patients with remanent diplopia after the reconstructions of orbital fracture were studied between January 2014 and June 2017. The different cause, operational occasions, and surgical techniques analyzed. All patients were followed for 6 months after the surgeries. After treatment, 64 patients with III degree diplopia were all performed the operations on extraocular muscles. Different operation was selected to different patients according to the examinational results of the extraocular muscles and passive drawer test, including rectos retropulsion, suspension, excise, Jensen's connection, and fixation to periorbital membrane. During the surgery, 25 patients had no diplopia in mainly functional visual fields, while 15 patients still had III degree diplopia. After 6 months, 27 patients had no diplopia in mainly functional visual fields, while 13 patients still had II degree diplopia. Among these 13 patients with III degree diplopia, 7 patients had no the diplopia of primary position of eye, and 6 patients had the diplopia of primary position. These 6 patients were suggested to wear the triangular prisms for improvement of the diplopia. The operations should be selected according to the examining results about eye movements and diplopia before and during the surgeries. Reasonable operations could correct diplopia and improve the eye movements effectually.

Functional visual fields: a cross-sectional UK study to determine which visual field paradigms best reflect difficulty with mobility function

ObjectivesTo develop an appropriate method of assessing visual field (VF) loss which reflects its functional consequences, this study aims to determine which method(s) of assessing VF best reflect mobility difficulty.SettingThis...

Functional visual fields: relationship of visual field areas to self-reported function.

The aim of this study is to relate areas of the visual field to functional difficulties to inform the development of a binocular visual field assessment that can reflect the functional consequences of visual field loss. Fifty-two participants with peripheral visual field loss undertook binocular assessment of visual fields using the 30-2 and 60-4 SITA Fast programs on the Humphrey Field Analyser, and mean thresholds were derived. Binocular visual acuity, contrast sensitivity and near reading performance were also determined. Self-reported overall and mobility function were assessed using the Dutch ICF Activity Inventory. Greater visual field loss (0-60°) was associated with worse self-reported function both overall (R2 = 0.50; p < 0.0001), and for mobility (R2 = 0.64; p < 0.0001). Central (0-30°) and peripheral (30-60°) visual field areas were similarly related to mobility function (R2 = 0.61, p < 0.0001 and R2 = 0.63, p < 0.0001 respectively), although the peripheral (30-60°) visual field was the best predictor of mobility self-reported function in multiple regression analyses. Superior and inferior visual field areas related similarly to mobility function (R2 = 0.56, p < 0.0001 and R2 = 0.67, p < 0.0001 respectively). The inferior field was found to be the best predictor of mobility function in multiple regression analysis. Mean threshold of the binocular visual field to 60° eccentricity is a good predictor of self-reported function overall, and particularly of mobility function. Both the central (0-30°) and peripheral (30-60°) mean threshold are good predictors of self-reported function, but the peripheral (30-0°) field is a slightly better predictor of mobility function, and should not be ignored when considering functional consequences of field loss. The inferior visual field is a slightly stronger predictor of perceived overall and mobility function than the superior field.

Evaluation of Functional Visual Acuity in Glaucoma Patients

We evaluated the association between functional visual acuity (FVA) and visual fields in glaucoma patients. Forty-seven patients with glaucoma were enrolled (28 men, 19 women; mean age: 65.2±7.3 y; range: 38 to 82 y), and their 94 eyes were studied. Inclusion criteria were having glaucomatous optic disc abnormalities, visual field loss with glaucoma, and a best-corrected visual acuity in each eye of 1.0 (equivalent to Snellen 20/20) or better. FVA and visual maintenance ratio evaluations were made with an AS-28 FVA measurement system. To assess FVA, Landolt optotypes were displayed sequentially for 2 seconds each, and the size was reduced when the patient gave the correct answer. Humphrey automated perimetry was performed to determine mean deviation (MD) and foveal threshold, and these values were used to evaluate associations between FVA and visual field. Mean and SD was calculated for all parameters for statistical comparisons. The MD values were -10.1±7.3 (range: -29.87 to 1.05) dB, and foveal thresholds were 34.8±2.8 (mean±SD, range: 25 to 41) dB. The logMAR FVA values were 0.14±0.17 (range: -0.14 to 0.73), and the visual maintenance ratios were 0.92±0.06 (range: 0.73 to 1.02). Linear regression analysis of the logMAR FVA values and visual field gave a MD of R=0.26 (P=0.01), and a foveal threshold of R=0.51 (P<0.001). The corresponding figures for the visual maintenance ratio and visual field were MD: R=0.25 (P=0.01) and foveal threshold: R=0.48 (P<0.001). The results of the current study showed that the logMAR FVA and visual maintenance ratio correlated moderately with foveal threshold.

Mental Rotation Ability of Individuals with Visual Impairments

The term mental rotation refers to a mental process during which individuals encode the spatial information into an image, rotate the image mentally, and then access the image in its new (Warren, 1994, pp. 107-108). Spatial perspective taking is based on a mental rotation process of the self. In spatial perspective taking, individuals seem to rotate themselves mentally into others' orientation to adopt their spatial perspective (Kessler & Thomson, 2010). The mental representation of space is essentially visual (Huttenlocher & Presson, 1973), and some of its aspects, such as perspective, are considered to be visually acquired (Arditi, Holtzman, & Kosslyn, 1988). However, there is another point of view according to which mental representation, even perspective (Heller et al., 2002), neither results from nor reflects visual perception (Millar, 1976). Paivio (1986) suggested that imagery can result from every sensory modality. Some studies have underlined the force of touch in specific tasks, by which individuals with visual impairments performed as well as or even better than their sighted counterparts (Heller, 1989; Heller, Brackett, Scroggs, & Allen, 2001; Noordzij, Zuidhoek, & Postma, 2007). Various studies have been conducted to evaluate mental rotation (Carpenter & Eisenberg, 1978; Dulin & Hatwell, 2006; Marmor & Zaback, 1976) and perspective taking (Millar, 1976) in individuals with visual impairments. The results suggested that visual imagery facilitates the performance of a mental rotation task (rotation of either an object or of the self). The aims of the study presented here were to examine the mental rotation ability of individuals with visual impairments and the effect of visual status, gender, and chronological age on this ability. For this purpose, two tests were conducted--the clock test and the room test. The first test was in essence a perspective task (Huttenlocher & Presson, 1973), and the second test was a mental manipulation task (Penrod & Petrosko, 2003). However, because both tests require conceptually difficult mental rotations (Millar, 1976), we refer to them both as mental rotation tests. METHOD Participants In our study, we followed the ethical principles of the Declaration of Helsinki. In addition, we obtained consent from the participants using the appropriate forms and according to the procedure suggested by the World Medical Association. Twenty-eight individuals with congenital visual impairments were selected, 15 boys and 13 girls, aged 6 years, 8 months, to 18 years (M = 12.37). The sample was randomly selected, and none of the participants had additional disabilities. Of the 28, 14 participants, aged 6 years, 8 months, to 17 years, were totally blind (from birth or prior to age 3) or had only light perception (M = 11.90), and 14 participants aged 8 years, 6 months, to 18 years, had residual vision (M = 12.85). The visual acuity of the participants with residual vision was better than 20/400 and worse than 20/200, and their central functional visual fields were better than 20 degrees (binocularly), examined through a confrontation method using a pen light. [FIGURE 1 OMITTED] Materials and design Three white cardboard squares measuring 25 x 25 centimeters (or about 10 x 10 inches) were used in the first test. In the center of the first square, a fixed, constant indicator made of black sandpaper was placed in a similar direction to that of a clock hand pointing to number 6 (see Figure 1, section a). Similarly, in the center of the second square, there was a fixed, constant indicator that pointed toward the clock position between numbers 7 and 8 (see Figure 1, section b) (hereafter position 6 and position 7.5). In the center of the third square there was an indicator that was fixed with a metal nail in such a way that it could be turned (see Figure 1, section c). …

Functional Visual Loss in Idiopathic Intracranial Hypertension

To identify and describe patients with idiopathic intracranial hypertension (IIH) with concurrent functional visual loss (FVL). Observational, retrospective case series. Seventeen patients with IIH and FVL. Clinical features were collected retrospectively. Data from 281 cases of IIH were analyzed for concurrence of FVL. Occurrence of FVL diagnosed at presentation or on subsequent follow-up. Seventeen patients had FVL and IIH. Of the 17 patients with FVL and IIH, 11 (65%) had FVL on presentation, with the remaining 6 patients developing FVL after initial presentation. Two patients in this cohort had documented recurrence of their IIH. There were several common patterns of FVL. All 17 patients had functional visual fields, with 82% having tubular fields and 71% exhibiting nonphysiologic constriction on perimetry testing. Seventy-six percent of patients had nerve/field mismatch showing no atrophic disc changes. Eighty-eight percent of patients had significant psychiatric, psychosocial, or other medical comorbidities. The majority of patients were managed surgically at some point in their clinical history, with 53% having nerve decompression, shunt, or both. Three patients had optic nerve sheath fenestrations after the diagnosis of FVL. Results suggest a high prevalence of FVL in IIH with a potential association with psychiatric illness and psychosocial stressors requiring careful consideration before surgical intervention. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Static and Dynamic Functional Visual Fields

The size of visual field utilized by the human visual system to input information about the outside world was investigated for static and dynamic viewing conditions. In static conditions, subjects detected a target that was presented in a peripheral position while maintaining central fixation. The size depended greatly on the imposed task: a large field to detect a spot of light, a small field to distinguish a target from background noise, and a still smaller field to distinguish a target from background noise while detecting a figure in the central visual field. In the dynamic condition, subjects read sentences or perceived pictures with restricted sizes of visual field and a critical field size was determined which assured normal perceptual behaviour. The size was about 10° visual angle in both cases, which was quite large compared to the saccadic size of the eye movement, implying a need to input the entire pattern for a limited time. Reasons for such short inputting times are discussed.