Inferior Visual Field Research Articles

Assessment of silent reading ability among glaucoma patients using an eye tracking system with horizontally scrolling text.

There have been many reports suggesting that glaucoma patients with visual field defects may have decreased silent reading ability compared with individuals without glaucoma. This study used an eye tracking system to assess the ability of glaucoma patients to silently read horizontally scrolling text. Glaucoma patients who met the following criteria were recruited: age of ≤ 70 years, at least one eye with a 10 - 2 threshold on standard automated perimetry, a mean deviation value of n 4.0 dB or less, and corrected decimal visual acuity of 0.7 or better in both eyes. Using heat map images created from data from an eye tracking system operating during presentation of a video in which a sentence scrolled horizontally from right to left, reading time, average gaze position, and average fixation time (AFT) were compared between normal eyes (23 individuals, 46 eyes) and glaucomatous eyes (25 patients, 45 eyes). Four styles of sentences (large slow, large fast, small slow, and small fast) were scrolled in the top or bottom sections of the screen. Primary open-angle glaucoma was the most common type of glaucoma in 34 eyes (75.6%), followed by secondary glaucoma in six eyes (13.3%). In comparison with normal eyes, the reading time among right eyes was significantly longer in glaucomatous eyes when reading large fast text that was shown in the bottom area and left glaucomatous eyes showed a leftward shift in gaze position in the top, bottom, or both sections with all four sentence types. There was no significant difference in AFT between glaucomatous and normal eyes across the four sentence styles. In the left eye with inferior visual field loss, text presented at the top consistently showed a correlation with leftward shift of the gaze position across all scenarios. Glaucoma patients with central visual field defects in their left eyes may experience greater difficulty reading horizontally scrolling text than individuals with normal eyes.

Contributions of Brain Microstructures and Metabolism to Visual Field Loss Patterns in Glaucoma Using Archetypal and Information Gain Analyses.

To investigate the contributions of the microstructural and metabolic brain environment to glaucoma and their association with visual field (VF) loss patterns by using advanced diffusion magnetic resonance imaging (dMRI), proton magnetic resonance spectroscopy (MRS), and clinical ophthalmic measures. Sixty-nine glaucoma and healthy subjects underwent dMRI and/or MRS at 3 Tesla. Ophthalmic data were collected from VF perimetry and optical coherence tomography. dMRI parameters of microstructural integrity in the optic radiation and MRS-derived neurochemical levels in the visual cortex were compared among early glaucoma, advanced glaucoma, and healthy controls. Multivariate regression was used to correlate neuroimaging metrics with 16 archetypal VF loss patterns. We also ranked neuroimaging, ophthalmic, and demographic attributes in terms of their information gain to determine their importance to glaucoma. In dMRI, decreasing fractional anisotropy, radial kurtosis, and tortuosity and increasing radial diffusivity correlated with greater overall VF loss bilaterally. Regionally, decreasing intra-axonal space and extra-axonal space diffusivities correlated with greater VF loss in the superior-altitudinal area of the right eye and the inferior-altitudinal area of the left eye. In MRS, both early and advanced glaucoma patients had lower gamma-aminobutyric acid (GABA), glutamate, and choline levels than healthy controls. GABA appeared to associate more with superonasal VF loss, and glutamate and choline more with inferior VF loss. Choline ranked third for importance to early glaucoma, whereas radial kurtosis and GABA ranked fourth and fifth for advanced glaucoma. Our findings highlight the importance of non-invasive neuroimaging biomarkers and analytical modeling for unveiling glaucomatous neurodegeneration and how they reflect complementary VF loss patterns.

A Case of Nonarteritic Anterior Ischemic Optic Neuropathy that Recurred in the same Eye within a Month

A 78-year-old woman presented with an upper visual field defect in the left eye. On ophthalmic examination, her best-corrected visual acuity (BCVA) was 1.2 in both eyes. Fundoscopy revealed inferior optic disc swelling. Goldmann visual field test showed an upper visual field defect. The patient was diagnosed with nonarteritic anterior ischemic optic neuropathy (NAION) of the left eye and was followed up without treatment. One month after the initial visit, her BCVA decreased to 0.15 in the left eye. Fundoscopy revealed superior optic disc swelling. Goldmann visual field test showed an inferior visual field defect and central relative scotoma. Based on her clinical findings, she was diagnosed with recurrent NAION. Three months after the initial visit, her BCVA was 0.2 in the left eye, and the optic nerve developed atrophy. This case highlights the importance for clinicians to be aware of NAION recurred in the same eye within a short period of time.

Correlation of retrobulbar perfusion deficits with glaucomatous visual field defects.

This study is to evaluate the correlation between retrobulbar perfusion deficits and glaucomatous visual field defects. Eighty-four patients with glaucoma and 17 normal subjects serving as controls were selected. Color Doppler imaging (CDI) was used to measure the changes in blood flow parameters in the retrobulbar ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCAs). Visual field testing was performed using a Humphrey perimeter, categorizing the visual field deficits into four stages according to the Advanced Glaucoma Intervention Study (AGIS) scoring method. Subsequently, the correlation of retrobulbar hemodynamic parameter alterations among glaucomatous patients with varying visual field defects was examined. The higher the visual field stage, the lower the peak systolic velocity (PSV) of the OA, CRA, and SPCAs in glaucomatous patients. The CRA had the highest sensitivity to changes in its PSV. The PSV of the temporal SPCA (TSPCA-PSV) was lower in advanced glaucoma than in early-stage glaucoma. The PSVs of the OA, CRA, and TSPCA, as well as the resistance index of the CRA (CRA-RI), were positively correlated with the visual field index and the mean deviation. Except for that of OA, the PSV of the retrobulbar vessels was negatively correlated with the pattern standard deviation (PSD). The OA-PSV and end-diastolic velocity (EDV) of the CRA and TSPCA were lower in patients with superior visual field defects than in those with inferior visual field defects. Greater severity of visual field defects corresponded to poorer retrobulbar blood flow in glaucomatous patients. Patients suffered significant perfusion impairments in the CRA at the early stage, accompanied by SPCA perfusion disorder at the advanced stage. The presence of a bow-shaped defect in the superior or inferior region of the visual field in moderate-stage glaucoma was closely correlated with retrobulbar vascular EDV. ChiCTR2200059048 (2022-04-23).

LONG-TERM FOLLOW-UP ON A RARE CASE OF PERIOPERATIVE POSTERIOR ISCHEMIC OPTIC NEUROPATHY: FINDING HOPE IN THE DARKNESS

Abstract
 Introduction : Perioperative posterior ischemic optic neuropathy (PION) following maxillectomy is a rare and devastating condition that leads to permanent vision loss in most reported cases. This case report offers a different perspective through long-term follow-up, providing valuable insights into the prognosis and potential treatments for PION.
 Case Illustration : Following a left maxillectomy for ameloblastoma, a 28-year-old female experienced sudden vision loss in her left eye. The visual acuity was 5/60, and an altitudinal inferior visual field defect with a superior extension was present. Ishihara's color vision examination revealed 15/38. The patient was diagnosed with perioperative PION and treated with neurotropic and folic acid. After 16 months, optic atrophy was observed. However, there are complete recovery in visual acuity to 5/5 and Ishihara score to 38/38, along with a significant improvement in the visual field defect.
 Discussion : The current management of perioperative PION is focused on prevention, because once vision loss occurs, it is usually severe and irreversible. In our case, the patient exhibited a favorable outcome after a long follow-up period, suggesting that there is still potential for improvement in PION patients. The finding is consistent with previous study, which reported that a small percentage of patients may still experience improved vision during follow-up. The role of neurotropics in improving patient outcomes is further supported by in vitro studies that demonstrate early neurotropic treatment significantly prevents loss of retinal ganglion cells in PION.
 Conclusion : Visual improvement is still possible in perioperative PION and early neurotropic administration may be considered in therapy

Correlation between Residual Sensitivity in the Central Inferior Nasal Visual Field and Visual Function in Chronic Leber Hereditary Optic Neuropathy Patients

Introduction: Leber hereditary optic neuropathy (LHON) is a maternally inherited, acute or subacute, optic neuropathy. The typical symptoms include reduced visual acuity and central scotoma. Despite the presence of deep central scotoma, some patients with LHON are able to perform daily activities. This study aimed to investigate the correlation between the residual visual field and visual acuity, critical flicker frequency, and fixation ellipse in patients with chronic LHON. Methods: Residual visual function (defined as sensitivity points where patients sensed the size V stimulus) of both eyes was evaluated in 10 patients with LHON carrying the m.11778 mitochondrial DNA mutation and with median age of onset and disease duration of 29 and 16.5 years, respectively. The central visual field was measured as static perimetry using the Humphrey visual field testing 30-2 program with the size III or V stimulus. Moreover, best-corrected visual acuity, critical flicker frequency, and the correlation between fixation ellipse and residual central visual fields were determined. The analysis was performed through a linear mixed-effects model. Results: The residual visual sensitivity in the inferior nasal visual field was significantly correlated with the logMAR (p < 0.05). The fixation ellipse fell within the residual visual field region with higher sensitivity. Conclusions: Patients with chronic LHON tended to retain the sensitivity detectable with the size V stimulus at the central inferior nasal visual field regions, where the fixation ellipse fell. Visual acuity, which influences daily activity, was spatially correlated with residual visual sensitivity.

The Relationship Between Kiritsu-Meijin-Derived Autonomic Function Parameters and Visual-Field Defects in Eyes with Open-Angle Glaucoma

Purpose This retrospective cross-sectional study aimed to investigate the association between autonomic parameters measured using the Kiritsu-Meijin device and visual-field defects in patients with open-angle glaucoma. Methods A total of 79 eyes of 42 patients with open-angle glaucoma were enrolled in this study. Kiritsu-Meijin testing comprised three phases: sitting, standing, and sitting again (2 min, 2 min, and 1 min, respectively). Continuous electrocardiograms were recorded for five minutes. Autonomic parameters were extracted from the resulting data and analyzed, including activity, balance, reaction, switchover, and recovery; these are five representative parameters derived from Kiritsu-Meijin testing. Correlations between these parameters and mean deviation from Humphrey visual field testing were determined. Additionally, we used a linear mixed-effects model to observe sectoral differences in the relationship between total deviation and the Kiritsu-Meijin parameters. In this study, we focused on superior, central, and inferior total deviations. Results Significant positive correlations were observed between activity, balance, and recovery and mean deviation values (β = 0.29–0.38, p < .05). The β value between activity and inferior total deviation was higher than that between activity and superior total deviation (β = 0.22, p < .05). Balance did not show any sectoral differences (p > .05). Recovery was more strongly associated with central to inferior total deviation than superior total deviation (β = 0.17–0.25, p < .05). Conclusion Our findings suggest that in patients with open-angle glaucoma, lower activity and recovery are associated with more severe central and/or inferior visual field defects in the superior quadrant. These results imply that measurements of autonomic function made with the Kiritsu-Meijin device may have clinical utility in the management of glaucoma.

A 48-year-old Caucasian man with unilateral "smudge" in inferior visual field.

To report an increasingly prevalent fundoscopic manifestation of syphilitic uveitis. Case report of a patient with acute retinal necrosis secondary to syphilis. A 48-year-old man presented with decreased vision, anterior segment inflammation, and a wedge-shaped retinal lesion in the superior periphery, with a diaphanous leading edge extending down towards the superior arcade. The patient was HIV+ and poorly compliant with therapy. The top three differential diagnoses were herpetic necrotizing retinitis, syphilis, and lymphoma. An extensive lab workup was positive for syphilis. The patient was treated with IV penicillin G and demonstrated improvement in visual acuity and exam. There have been an increasing number of reports of syphilis patients, especially in the population of men who have sex with men, who present with fundus findings similar to acute retinal necrosis. These findings include a characteristic ground glass, translucent appearance of unifocal or multifocal lesions, primarily affecting the inner retina and sometimes associated with co-localizing occlusive vasculitis. Treatment with IV penicillin G is warranted and has demonstrated good visual recovery.

HSV-2 Retinitis and Encephalitis Masquerading as Giant Cell Arteritis and Acute Ischemic Stroke of the Midbrain (P12-10.002)

<h3>Objective:</h3> To describe a unique case of stroke mimicry. <h3>Background:</h3> Non-vascular causes of acute neurological symptoms may clinically and radiographically mimic ischemic strokes. In the brainstem, such considerations are generally restricted to neoplastic, demyelinating, or infectious etiologies. HSV-2 may very rarely cause isolated mesencephalitis. <h3>Design/Methods:</h3> We describe a patient who presented with headache, arthralgias, and visual dysfunction who was initially diagnosed with giant cell arteritis (GCA) but was eventually found to have HSV-2 infection. <h3>Results:</h3> A 75-year-old man with past medical history notable for atrial fibrillation (on apixaban), hypertension, hyperlipidemia, and rheumatoid arthritis (on adalimumab) presented for evaluation of gait instability. Four weeks prior to presentation, he developed bitemporal headaches without visual symptoms and arthralgias. His rheumatologist checked an ESR (40) and ordered a temporal artery biopsy. He presented the day his apixaban was held prior to biopsy (1 week prior to this presentation) with right eye inferior visual field loss. Fundoscopy revealed disc edema felt consistent with anterior ischemic optic neuropathy. He was treated with pulse-dose steroids out of concern for GCA and underwent bilateral temporal artery biopsy before being discharged home on an oral steroid taper and resumed anticoagulation. CT, CTA, and MRI were reportedly normal and the biopsies were ultimately negative. He then presented this admission with gait instability and MRI exhibited a diffusion restricting lesion with T2-FLAIR hyperintensity without hemorrhage in the left cerebral peduncle. His visual symptoms progressed and he underwent right eye anterior chamber paracentesis with fluid resulting PCR positive for HSV-2. Subsequent CSF sampling also revealed lymphocytic pleocytosis and HSV-2 positivity. Despite maximal medical therapy, he lost vision in both eyes over a matter of weeks before developing Charles-Bonnet syndrome. <h3>Conclusions:</h3> HSV-2 encephalitis may cause mesencephalic, non-hemorrhagic, restricting lesions mimicking acute ischemic stroke. HSV may also cause a necrotizing retinitis, initially mimicking ischemic, even arteritic, optic neuropathy. <b>Disclosure:</b> Dr. Sutherland has received personal compensation in the range of $0-$499 for serving as a Consultant for McGraw-Hill. Dr. Gummerson has nothing to disclose. Dr. De Havenon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Integra. Dr. De Havenon has stock in Certus. The institution of Dr. De Havenon has received research support from NIH/NINDS. The institution of Dr. De Havenon has received research support from Regeneron Pharmaceuticals. The institution of Dr. De Havenon has received research support from AMAG Pharmaceuticals. The institution of Dr. De Havenon has received research support from AMGEN. Dr. De Havenon has received publishing royalties from a publication relating to health care.

The Role of Optical Coherence Tomography Angiography in Non-Arteritic Ischemic Optic Neuropathy: A Case Report

Introduction: Non-arteritic ischemic optic neuropathy (NAION) is the second most common optic neuropathy in adults. Since circulatory insufficiency is presumed to have a role in pathogenesis of NAION, optical coherence tomography angiography (OCTA) is suggested as a tool in assessing NAION patients, while optical coherence tomography (OCT) can detect structural changes. This case report aims to describe the congruity of visual field defect with OCT and OCTA result in a case of bilateral NAION, highlighting the role of both OCT and OCTA in NAION. Case Report: A 52-years-old male came due to painless, progressive blurry vision in both eyes, especially in lower visual field, for the past 7 months. Humphrey visual field examination revealed inferior visual field defects in both eyes. OCTA showed reduced retinal perfusion in the superior part bilaterally. OCT revealed ganglion cell loss in the superior part of his right eye and almost all parts of his left eye. Retinal nerve fiber layer (RNFL) thinning was found in the superior part bilaterally. Discussion: In this case, the congruity of visual field defect, reduced perfusion, ganglion cell-inner plexiform layer (GCIPL), and RNFL thinning portrayed the connection of hypoperfusion as the presumed underlying mechanism of NAION, neuron loss as the result of the hypoperfusion, and the visual field loss as the presenting symptom in NAION. Conclusion: This finding demonstrates the role of OCT-A and OCT in diagnosing and monitoring progression in patients with NAION.OCT-A is a useful tool to evaluate microvascular changes, while OCT can be used to evaluate RNFL and GCIPL thinning.

Paracentral Acute Middle Maculopathy in a Patient with Cilioretinal Artery Occlusion

Introduction: A 49-year-old woman presented at Inoda Eye Clinic with inferior visual field defect in the left eye. Ophthalmoscopic examination revealed well-demarcated retinal edema of the superior region at the posterior pole in the left eye. The area of retinal edema was consistent with the area of the cilioretinal artery, and therefore, cilioretinal artery occlusion was suspected. Optical coherence tomography showed hyperreflective bandlike lesions involving the middle layers of the retina at the level of the inner nuclear layer. Optical coherence tomography angiography showed decreased flow sign in outer retina layer and choriocapillaris layer rather than in superficial layer. Based on these findings, the patient was diagnosed with paracentral acute middle maculopathy due to cilioretinal artery occlusion. Optical coherence tomography angiography is a useful diagnostic examination instead of fluorescein angiography for evaluation of cilioretinal artery occlusion.

Successful outcome of paediatric cytomegalovirus optic neuritis treated with combined steroid and valganciclovir: A case report

AbstractPurpose: To report the clinical approach for diagnosis and management of paediatric optic neuritis.Methods: A 13 years old girl patient came to the emergency room with complaints of sudden blurred vision in both eyes and pain with eye movement. On Ophthalmic examination, the visual acuity in the right eye was 6/30 and the left eye was no light perception. There was a positive relative afferent pupillary defect in the left eye. Both the optic disc was swollen. The colour vision was abnormal and there was inferior visual field defect. Laboratory examination showed an increase leukocyte, increase in cytomegalovirus (CMV) immunoglobulin G (IgG) antibody, and decrease in cluster of differentiation 4 (CD4) cell. The head and orbital MRI did not show any intracranial pathological lesion. The patient was diagnosed with optic neuritis caused by CMV and treated with intravenous methylprednisolone 250 mg every 6 h for 3 days followed by oral prednisone 1 mg/kg daily and valganciclovir 16 mg/kg daily for 3 weeks.Results: After 3 days of only intravenous steroid treatment, her visual acuity improved to 6/9 in right eye and 1/300 in left eye. The vision increase significantly to 6/6 in the right eye and 6/7.5 in the left eye after 1 month treated with combined steroid and valganciclovir.Conclusions: A comprehensive examination, includes history taking, optic nerve examination, laboratory and serology tests related to infection, also head and orbital MRI to rule out other causes is important in the management of paediatric optic neuritis. Appropriate treatment with IV methylprednisolone and valganciclovir provide a better visual prognosis for paediatric CMV optic neuritis.

Assessing the contrast sensitivity function in myopic parafovea: A quick contrast sensitivity functions study.

PurposeCompare peripheral contrast sensitivity functions (CSF) between myopes and emmetropes to reveal potential myogenic risks during emmetropization.Materials and methodsThis observational, cross-sectional, non-consecutive case study included data from 19 myopes (23.42 ± 4.03 years old) and 12 emmetropes (22.93 ± 2.91 years old) who underwent central and peripheral quick CSF (qCSF) measurements. Summary CSF metrics including the cut-off spatial frequency (cut-off SF), area under log CSF (AULCSF), low-, intermediate-, and high-spatial-frequency AULCSFs (l-, i-, and h-SF AULCSFs), and log CS at 19 SFs in the fovea and 15 peripheral locations (superior, inferior, temporal, and nasal quadrants at 6, 12, 18, and 24° eccentricities, excluding the physiological scotoma at 18°) were analyzed with 3-way and 4-way between-subjects analysis of variance (ANOVA) (α = 0.05).ResultsThree-way ANOVA showed that myopes had significantly increased AULCSF at 6° (mean difference, 0.08; 95% CI, 0.02–0.13; P = 0.007) and 12° (mean difference, 0.09; 95% CI, 0.03–0.14; P = 0.003). Log CS at all 19 SFs were higher in the myopia group compared to the normal group (mean differencesuperior, 0.02; 95% CI, 0.01–0.20; P = 0.02 and mean differenceinferior, 0.11; 95% CI, 0.02–0.21; P = 0.01) at 12°. The h-SF AULCSF at 6° (mean differenceinferior, 1.27; 95% CI, 0.32–2.22; P = 0.009) and i-SF AULCSF at 12° (mean differencesuperior, 5.31; 95% CI, 4.35–6.27; P < 0.001; mean differenceinferior, 1.14; 95% CI, 0.19–2.10; P = 0.02) were higher in myopia vs. normal group.ConclusionWe found myopia increased contrast sensitivity in superior and inferior visual field locations at 6° parafoveal and 12° perifoveal regions of the retina. The observation of increased contrast sensitivities within the macula visual field in myopia might provide important insights for myopia control during emmetropization.

Shot in the dark

A 43-year-old woman presented with decreased vision in the right eye associated with painful eye movements 10 days after receiving her first dose of Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine (Pfizer Inc, New York, NY). Two days later she developed painful loss of vision in the left eye. Clinical presentation and magnetic resonance imaging findings were consistent with bilateral optic perineuritis transitioning to optic neuritis. Extensive evaluation including aquaporin-4 immunoglobin G (IgG), myelin oligodendrocyte glycoprotein IgG, and lumbar puncture was unrevealing. Visual acuity at nadir was counting fingers in both eyes, but after receiving intravenous steroids and plasma exchange vision eventually improved to 20/20 in each eye, although she was left with inferior visual field defects and bilateral optic disc pallor. This case highlights the diagnostic challenge in the evaluation of atypical optic neuritis with a review of post-COVID-19 vaccination-associated optic neuritis.

Effects of visual span on Chinese reading performance in normal peripheral vision

The current study examined the relationships among temporal processing speed, spatial visual span and Chinese character reading speed in normal central and peripheral vision. Maximum reading speed (MRS) and critical print size (CPS) of 26 native Chinese readers (13 young and 13 older adults) were determined at three visual field locations: central vision, 10° left and 10° below fixation using a rapid serial visual presentation (RSVP) task. Temporal processing speed was measured using trigrams of randomly selected Chinese characters presented at a range of exposure durations, while spatial visual span was measured using trigrams presented at different spatial positions. It was found that shorter temporal processing speed and larger spatial visual span were associated with faster MRS at the central and inferior visual field locations, but not at the left of fixation location. As expected, reading and visual span metrics were better in central vision compared to both peripheral locations. In addition, reading, temporal processing, and spatial visual span metrics were better in the young than older subjects (except for similar temporal processing speed at two peripheral locations). The results for central and inferior presentation locations support the hypothesis that temporal processing speed and spatial visual span were associated with Chinese character reading speed. Surprisingly, no correlation was observed for the 10° left of the fixation location, suggesting that the factors affecting reading speed might differ for inferior and lateral peripheral viewing locations.

Compressive Optic Neuropathy Caused by Internal Carotid Artery Aneurysm Presenting with Concurrent Neuromyelitis Optica

Purpose: To report a case of compressive optic neuropathy caused by an internal carotid artery aneurysm accompanied by concurrent neuromyelitis optica (NMO).Case summary: A 48-year-old female presented with sudden painless blurry vision in the inferior visual field of her right eye for 2 days. The corrected visual acuity was 0.7 in the right eye, and a relative afferent pupillary defect was observed. The visual field test demonstrated an inferior altitudinal defect in the right eye, while the color vision test was normal. However, after 5 days, she developed decreased color vision. Optic nerve enhancement in the right eye was observed on orbital magnetic resonance imaging, and anti-aquaporin-4 antibody was positive. She was diagnosed with NMO, and high-dose steroids were administered intravenously. In addition, brain magnetic resonance angiography showed a 5-mm aneurysm in the ophthalmic segment of the right internal carotid artery, which was compressing the optic nerve. Coil embolization of the aneurysm was performed. On the fourth day of steroid therapy and the first day after coiling, the corrected visual acuity in the right eye improved to 1.0. At 6-week follow-up, color vision and visual field defect also showed complete recovery.Conclusions: In this rare case of internal carotid artery aneurysm combined with NMO, early active treatment led to complete recovery of visual acuity and field defects.

Border tissue morphology is associated with the pattern of visual field progression in open-angle glaucoma

The etiology of open-angle glaucoma (OAG) is yet unclear. This study investigated possible risk factors, such as the morphology of the border tissue that affect the pattern of visual field (VF) progression in eyes with OAG. 166 eyes of 166 OAG patients with an externally oblique border tissue (EOBT) at least in one direction were included. EOBT was obtained by analyzing enhanced depth imaging spectral-domain optical coherence tomography images. A pointwise linear regression was used to determine VF progression by measuring the deterioration rate of each point in the VF. The odds ratio of VF progression for each risk factor was estimated using logistic regression analysis. Seventy (42.2%) eyes showed VF deterioration. In multivariate analysis, longer follow-up period, higher baseline intraocular pressure (IOP), lower mean ocular perfusion pressure (MOPP), and smaller angular location of the longest EOBT were associated with VF progression (all p values were below 0.05). In the multivariate analysis, the location of the longest EOBT was significantly associated with inferior (p = 0.002) and central (p = 0.017) VF progression. In conclusion, VF progression pattern in OAG eyes is associated with the location of the longest EOBT as well as other known risk factors.

A case report of rehabilitation of bilateral inferior field defect with Peli prisms

Bilateral inferior visual field loss (BIVFL) is a rare entity, and rehabilitation of such patients can be challenging. Peli prisms are a good option for visual rehabilitation in horizontal homonymous hemianopias. Here we present an interesting case of BIVFL with macular sparing, successfully rehabilitated with a novel vertical orientation of Peli prism.

Comparative Evaluation of Two SD-OCT Macular Parameters (GCC, GCL) and RNFL in Chiasmal Compression.

PurposeTo evaluate the relationship between different macular thickness parameters analyzed by SD-OCT and the central visual field (VF) evaluated with automated kinetic perimetry in a cohort of patients with pituitary tumors.MethodsData from patients with pituitary adenoma treated at Reims University Hospital between October 1st, 2017, and May 31st, 2018 were collected. All patients underwent an automated kinetic perimetry and a SD-OCT to map the ganglion cell complex (GCC), the ganglion cell layer (GCL) thickness and the retinal nerve fiber layer (RNFL) using devices from two different manufacturers. Univariate and multivariate analysis were used to evaluate the correlation between the area of central VF in square degrees (deg2) and the SD-OCT parameters (μm).ResultsEighty-eight eyes were included in the analysis. All the thickness parameters measured in SD-OCT decreased with the visual field alteration. The best correlation was observed between superior thickness parameters (GCC, GCL) and the inferior central visual field. The most pertinent predictive factors for visual field loss were the inferior central GCL and the nasal RNFL (both AUC=0.775) with a sensitivity respectively of 86% and 70%.ConclusionThis study suggests that both GCC, GCL thickness parameters could be reliable predictors of central visual field impairment in patients with pituitary tumors. There was no significative difference between both devices.

The Relationship Between Optic Disc and Retinal Artery Position and Glaucomatous Visual Field Progression

PurposeTo investigate whether retinal structural parameters, including positions of the optic disc and major retinal arteries, affect glaucomatous progression of the visual field (VF).MethodsIn this cohort study, 116 eyes of 73 patients with primary open angle glaucoma (POAG) were included. VFs were measured using the Humphrey Field Analyzer 24-2 program and the VF was divided into seven sectors according to the corresponding optic disc angle. Average total deviation (TD) was calculated in each sector. Positions of major retinal arteries in the superotemporal and inferotemporal areas were decided by identifying the points where the retinal artery intersected the 3.4-mm-diameter circle around the optic disc. The relationship between sectorial TD VF progression rate and eight variables (age, mean and standard deviation of intraocular pressure during the observation period, baseline sectorial TD value, papillomacular bundle tilt angle, and axial length, along with superior/inferior arterial angle) was investigated.ResultsThe main outcome measures were the association between retinal structural parameters and glaucomatous progression of VF. The superior retinal artery angular position was positively associated with sectorial TD progression rates in two central sectors in the inferior hemifield, which suggests faster VF progression where superior retinal artery angles are narrow. Papillomacular bundle tilt was not associated with TD progression rate in any sector.ConclusionsProgression of the inferior VF was associated with the superior retinal artery angular position in this study of POAG.