Peripheral Visual Field Research Articles

Brimonidine is Neuroprotective in Animal Paradigm of Retinal Ganglion Cell Damage.

To investigate the neuroprotective effect of brimonidine after retinal ischemia damage on mouse eye. Glaucoma is an optic neuropathy characterized by retinal ganglion cells (RGCs) death, irreversible peripheral and central visual field loss, and high intraocular pressure. Ischemia reperfusion (I/R) injury model was used in C57BL/6J mice to mimic conditions of glaucomatous neurodegeneration. Mouse eyes were treated topically with brimonidine and pattern electroretinogram were used to assess the retinal ganglion cells (RGCs) function. A wide range of inflammatory markers, as well as anti-inflammatory and neurotrophic molecules, were investigated to figure out the potential protective effects of brimonidine in mouse retina. In particular, brain-derived neurotrophic factor (BDNF), IL-6, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and its death receptor DR-5, TNF-α, GFAP, Iba-1, NOS, IL-1β and IL-10 were assessed in mouse retina that underwent to I/R insult with or without brimonidine treatment. Brimonidine provided remarkable RGCs protection in our paradigm. PERG amplitude values were significantly (p < 0.05) higher in brimonidine-treated eyes in comparison to I/R retinas. Retinal BDNF mRNA levels in the I/R group dropped significantly (p < 0.05) compared to the control group (normal mice); brimonidine treatment counteracted the downregulation of retinal BDNF mRNA in I/R eyes. Retinal inflammatory markers increased significantly (p < 0.05) in the I/R group and brimonidine treatment was able to revert that. The anti-inflammatory IL-10 decreased significantly (p < 0.05) after retinal I/R insult and increased significantly (p < 0.05) in the group treated with brimonidine. In conclusion, brimonidine was effective in preventing loss of function of RGCs and in regulating inflammatory biomarkers elicited by retinal I/R injury.

Usher Syndrome: A Case Report of Two Brothers

Purpose: To report a case of Usher’s syndrome in two brothers. Case Report: Two brothers, 24 and 26 years of age, presented to Chittagong eye infirmary and training complex with the complaints of gradual diminution of vision in both eyes, especially at night. Their ocular examination revealed best corrected visual acuity of 6/36 in right eye and 6/24 in left eye. Dilated fundus evaluation showed pigmentary retinopathy. Perimetry revealed peripheral visual field constriction. Their systemic examination revealed sensorineural hearing loss. These clinical findings supported the diagnosis of Usher syndrome Type 1. The patients were advised for low vision aids to improve their quality of life and counseling regarding the prognosis of the disease was done with the patient’s family members. Conclusion: Early detection and appropriate intervention will help preserve the residual vision.

Prospective study of dietary intake of branched-chain amino acids and the risk of primary open-angle glaucoma.

Metabolomic and preclinical studies suggest that branched-chain amino acids (BCAA) may be inversely associated with neurodegenerative diseases including glaucoma. We therefore assessed the long-term association between dietary intake of BCAA and incident primary open-angle glaucoma (POAG) and POAG subtypes. We followed biennially participants of the Nurses' Health Study (NHS; 65 531 women: 1984-2016), Health Professionals Follow-up Study (42 254 men: 1986-2016) and NHSII (66 904 women; 1991-2017). Eligible participants were 40+ years old and reported eye examinations. Repeated validated food frequency questionnaires were used to assess dietary intake of BCAA. Incident cases of POAG and POAG subtypes defined by visual field (VF) loss and untreated intraocular pressure (IOP) were confirmed by medical record review. Multivariable-adjusted relative risks (MVRRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. We identified 1946 incident POAG cases. The pooled MVRRs of POAG for the highest quintile (Q5 = 17.1 g/day) versus lowest quintile (Q1 = 11.2 g/day) of total BCAA intake was 0.93 (95% CI, 0.73-1.19; ptrend = 0.45; pheterogeneity by sex = 0.24). For subtypes of POAG defined by IOP level or POAG with only peripheral VF loss, no associations were observed for men or women (ptrend ≥ 0.20); however, for the POAG subtype with early paracentral VF loss, there was a suggestion of an inverse association in women (MVRRQ5versusQ1 = 0.80 [95% CI, 0.57-1.12; ptrend = 0.12]) but not in men (MVRRQ5versusQ1 = 1.38 [95% CI, 0.81-2.34; ptrend = 0.28; pheterogeneity by sex = 0.06]). Higher dietary intake of BCAA was not associated with POAG risk.

Concurrence of craniopharyngioma and meningioma: a case report and systematic review of the literature

Craniopharyngioma (CPG) is a benign epithelial tumor that originates from Rathke’s pouch. Meningiomas (MNG) are neoplasms of meningothelial cell. The patient is a 42-year-old female who presented with left-sided temporal headaches and visual acuity impairment. Neurological examination revealed bilateral peripheral visual field defects. Imaging of the brain showed a hypointense solid-cystic sellar lesion with suprasellar extension without calcification which enhanced with contrast. Also present was a second, contrast-enhancing extra axial lesion overlying the olfactory groove. The patient had no history of tumor surgery or radiation therapy. Both of the lesions were operated for resection and post operation status was uneventful. This study reports non-radiation related co-occurrence of a craniopharyngioma (CPG) and a meningioma (MNG). We reviewed published articles between 1966 and 2020, and found that although MNGs are the most commonly occurring brain tumors, the occurrence of MNG and CPG together with no relation to radiation is relatively rare, reported only 7 times in living patients. By analyzing the data and keeping in mind that there is no proven common genetic background and risk factor between them, their co-occurrence, shows the importance of further investigation to clear any possible relationship between the two other than mere coincidence.

Characteristics of Central Visual Field Progression in Eyes with Optic Disc Hemorrhage

To investigate the characteristics and rate of central visual field loss after optic disc hemorrhage (DH). Prospective cohort study. Three hundred forty-three eyes of 220 subjects who had ≥3 years of follow-up with a minimum of 5 visits with 10-2 and 24-2 visual field (VF) were recruited. Rates of 10-2 mean deviation (MD) loss in each hemifield and predefined zones were compared using linear mixed-effects models in DH and non-DH eyes. Clustered pointwise regression analysis was also used to define central VF progressors and compared with 24-2 VF loss using guided progression analysis. Thirty-nine eyes with DH and 304 eyes without DH had a mean follow-up of 5.2 years. Eyes with DH had rates of 10-2 MD loss that were 3 times faster than non-DH eyes (mean difference -0.36 dB/year [95% confidence interval 0.54-0.18]; P < .001) and were 3.7 times more likely to progress (P=.002). A larger proportion of glaucomatous eyes showed central VF progression rather than peripheral VF progression in the DH group (30.8% vs. 20.5%) compared with the non-DH group (10.9% vs. 9.2%). In early glaucoma, the rate of 10-2 MD loss was 5.5 times faster in DH eyes than in non-DH eyes (P < .001). Superonasal and superotemporal central VF regions progressed more rapidly than other regions, especially in DH eyes. Central VF loss is accelerated in glaucoma eyes with DH and it corresponds topographically to the DH location. In patients with glaucoma with DH, one should consider supplementing 10-2 VFs with 24-2 VFS to monitor the disease.

A bias in saccadic suppression of shape change

Processing of visual information in the central (foveal) and peripheral visual field is vastly different. To achieve a homogeneous representation of the visual world across eye movements, the visual system needs to compensate for these differences. By introducing subtle changes between peripheral and foveal inputs across saccades, one can test this compensation. We morphed shapes between a triangle and a circle and presented two different change directions (circularity decrease or increase) at varying magnitudes across a saccade. In a change-discrimination task, observers disproportionally often reported percepts of circularity increase. To test the relationship with visual-field differences, we measured perception when shapes were exclusively presented either in the periphery (before a saccade), or in the fovea (after a saccade). We found that overall shapes were perceived as more circular before than after a saccade and the more pronounced this difference was for a participant, the smaller was their circularity-increase bias in the change-discrimination task. We propose that visual-field differences have a direct and an indirect influence on transsaccadic perception of shape change. The direct influence is based on the distinct appearance of shape in the central and peripheral visual field in a trial, causing an increase of the perceptual magnitude of circularity-decrease changes. The indirect influence is based on long-term build-up of transsaccadic expectations; if a change is opposite (circularity increase) to the expectation (circularity decrease), it should elicit a strong error signal facilitating change detection. We discuss the concept of transsaccadic expectations and theoretical implications for transsaccadic perception of other feature changes.

Object-Gaze Distance: Quantifying Near- Peripheral Gaze Behavior in Real-World Applications.

Eye tracking (ET) has shown to reveal the wearer’s cognitive processes using the measurement of the central point of foveal vision. However, traditional ET evaluation methods have not been able to take into account the wearers’ use of the peripheral field of vision. We propose an algorithmic enhancement to a state-of-the-art ET analysis method, the Object- Gaze Distance (OGD), which additionally allows the quantification of near-peripheral gaze behavior in complex real-world environments. The algorithm uses machine learning for area of interest (AOI) detection and computes the minimal 2D Euclidean pixel distance to the gaze point, creating a continuous gaze-based time-series. Based on an evaluation of two AOIs in a real surgical procedure, the results show that a considerable increase of interpretable fixation data from 23.8 % to 78.3 % of AOI screw and from 4.5 % to 67.2 % of AOI screwdriver was achieved, when incorporating the near-peripheral field of vision. Additionally, the evaluation of a multi-OGD time series representation has shown the potential to reveal novel gaze patterns, which may provide a more accurate depiction of human gaze behavior in multi-object environments.

Multimodal imaging of bilateral ischemic retinal vasculopathy associated with Berger\u2019s IgA nephropathy: case report

BackgroundBerger’s IgA nephropathy (IgAN) is the most common primary glomerulonephritis. However, some rare cases of retinal manifestations have been described, with only two cases of retinal vasculopathy reported in the literature.Here we report an uncommon case of bilateral ischemic retinal vasculopathy associated with Berger IgAN, evaluated with complete multimodal imaging including ultra-wide field (UWF) imaging and swept source optical coherence tomography angiography (SS-OCTA).Case presentationA 51-year-old woman with a history of Berger’s IgA nephropathy complained of visual impairment in both eyes. Fundus examination showed bilateral peripapillary arterial attenuation and perivascular sheathing, associated to perifoveal telangiectatic lesions. There was a central scotoma in the perimetry of the right eye and peripheral visual field defect in the left eye. Full-field electroretinogram revealed significantly reduced oscillatory potentials. Spectral domain optical coherence tomography showed multiple focal areas of thinning of the inner retina, indicating long-lasting vascular occlusion lesions. UWF fluorescein angiography showed the presence of bilateral vasculitis, diffuse capillary leakage, macular ischemia and telangiectasia. SS-OCTA better highlighted the macular ischemia and vascular anomalies layer-by-layer.ConclusionsRetinal vasculopathy is a very rare condition observed in IgA nephropathy. To our knowledge, this is the first report of complete multimodal functional and structural imaging. UWF imaging was very useful for accurate and comprehensive disease assessment, and OCTA was able to assess posterior pole vascular lesions.

Acknowledging the Blind Spot of Bitemporal Hemianopsia: Keeping a High Index of Suspicion for Pituitary Macroadenomas in Uncommon Presentations

Background: Hyperglycemia in patients with type 2 diabetes mellitus commonly manifests as symptoms of polyuria, polydipsia, fatigue, and weight loss as a result of insulin resistance. In cases of severe hyperglycemia, patients may also experience visual disturbances and dizziness as a result of swelling of the lens and dehydration respectively. These symptoms are not generally accompanied by gait disturbance or fixed, focal deficits on neurological examination. As such, symptoms such as double vision, peripheral field vision loss, cranial nerve deficits, or significant unsteadiness may warrant a more extensive neurologic workup rather than simply attributing all symptoms to hyperglycemia. Clinical Case: A 57-year-old woman presented to the emergency department with five days of fatigue, polyuria, polydipsia and pre-syncope associated with dizziness. She also described double vision in her peripheral visual fields and episodes of gait disturbances causing her to have to lower herself to the ground on multiple occasions, without loss of consciousness. Her neurologic examination demonstrated mildly ataxic finger-to-nose testing and concern for peripheral field vision loss. Intake lab work revealed a blood glucose of 725 mg/dL and a hemoglobin A1C of 13.4%. Initial neuroimaging with computed tomography was unremarkable. Though her symptoms were thought to be due to severe hyperglycemia, an MRI brain was obtained due to abnormal neurologic examination. MRI demonstrated a 1.9 cm pituitary macroadenoma abutting the optic chiasm with concern for hemorrhage. Subsequent lab evaluation determined the pituitary macroadenoma non-functional with TSH, free T4, free T3, AM cortisol, AM ACTH, and prolactin all within normal limits. Her hyperglycemia was treated with insulin with clinical improvement in all regards except visual symptoms. She was deemed safe for discharge with neurosurgical follow-up regarding surgical removal of her macroadenoma. Conclusion: Although hyperglycemia may present with broad symptoms including vague neurologic symptoms, it is critical to keep a broad differential diagnosis when atypical symptoms such as persistent vision changes and gait disturbances are present, especially after improvement in glycemic control has been obtained. A low threshold should be held for obtaining neuroimaging, as it is prudent to rule-out life-threatening causes of neurologic dysfunction.

Naturalistic Driving Techniques and Association of Visual Risk Factors With At-Fault Crashes and Near Crashes by Older Drivers With Vision Impairment

Government motor vehicle crash reports used in the study of driver safety can be biased and incomplete. Naturalistic driving methods using in-vehicle instrumentation have been developed in recent years to objectively measure crashes and near crashes as they occur on the road using video and vehicle kinematic data. To examine visual risk factors associated with at-fault crashes and near crashes among older drivers, most of whom have age-related eye conditions associated with vision impairment. This prospective cohort study was conducted at an academic ophthalmology clinic from January 1, 2015, to November 10, 2018, among 154 adults 70 years of age or older who were legally licensed in Alabama and who reported currently driving at least 4 days per week; 137 of 151 participants (90.7%) had an age-related eye condition in at least 1 eye. Drivers participated in a baseline visual function assessment followed by installation of a data acquisition system recording multichannel synchronized video and vehicle kinematics in their personal vehicle. Drivers were instructed to drive for 6 months as they normally would during everyday life. Statistical analysis was performed from June 15 to September 15, 2020. The rate of combined incident at-fault crashes and near crashes, defined by the number of events and the number of miles driven. The sample consisted of 154 drivers (85 men [55.2%]; mean [SD] age, 79.3 [5.1] years). Visual functions associated with crash and near-crash involvement included impaired contrast sensitivity (rate ratio [RR], 2.7; 95% CI, 1.3-5.5), moderate (RR, 2.3; 95% CI, 1.1-4.9) and severe (RR, 5.0; 95% CI, 2.2-11.7) slowing in visual processing speed, and elevated motion perception thresholds for a drifting grating (RR, 1.9; 95% CI, 1.1-3.5). Those with impaired peripheral visual field sensitivity had increased rates of crashes and near crashes (RR, 1.8; 95% CI, 1.0-3.3); however, this finding was not statistically significant (P = .07). With the use of naturalistic driving methods in which crashes and near crashes involving older drivers are objectively measured as they occur on the road, associations have been identified between impaired contrast sensitivity, slowed visual processing speed, and impaired motion perception and an increased rate of a combined total of at-fault crashes and near crashes.

Relationship between peripheral vasospasm and visual field progression rates in patients with normal-tension glaucoma with low-teen intraocular pressure.

PurposeTo investigate the association between peripheral vasospasm and the visual field (VF) progression rate in patients with normal-tension glaucoma (NTG) with low-teen intraocular pressure (IOP).MethodsThe finger temperature of 113 NTG patients was measured before and after exposure to ice water using a Temperature gun (cold pressor test). These patients had confirmed VF progression, despite a low-teen IOP during a follow-up period of >5 years. VF progression rates were calculated as the slope of the visual field index (VFI) and mean deviation (MD) over time. Demographic, systemic, and ocular factors and VF progression rates were compared, based on the cold pressor test results. A regression analysis was used to investigate the factors affecting VF progression rates.ResultsMean age, initial IOP, mean IOP during the follow-up period, and initial VF MD were 57.1 years, 15.8 mmHg, 12.0 mmHg, and -5.2 dB, respectively. When patients were divided into two groups (less vasospasm and more vasospasm) according to changes in temperature after exposure to ice water, the VF progression rate was significantly faster in the group with more vasospasm. In a multiple regression analysis, older age, worse initial VF MD, and greater decrease in finger temperature after ice water exposure were significantly associated with faster VF progression rates.ConclusionAn excessive drop in finger temperature after exposure to ice water was significantly associated with faster VF progression in patients with low-teen NTG. This suggests that the blood flow in the optic nerve head may also be disturbed by peripheral vasospasm, accelerating glaucomatous damage regardless of IOP.

Аutosomal Dominant Oculodental-Digital Dysplasia with Mutation in Gene GJA1 (Clinical Case)

The purpose: to describe clinical cases of oculodental-digital dysplasia (ODDD, OMIM #164200) with mutation in GJA1 (OMIM 121014) with molecular genetic verification of the diagnosis.Methods. The article describes the clinical case of oculodental-digital dysplasia in a 51 years old patient. Patient underwent full ophthalmic examination including autorefractometry, visual acuity testing with full correction, tonometry, biomicroscopy, fundus examination and photo as well as kinetic perimetry, autofluorescence and optical coherence tomography (OCT) of macula and optic disk were performed. Electrophysiological examination included Visual Evoked Potentials (VEP) to flash and pattern stimulation, ISCEV standard electroretinograms (ERG) and macular ERG. For the verification of the diagnosis and pathologic gene molecular genetic examination was performed with family anamnesis previously attained.Results. The patient was complaining the deterioration of vision, hearing loss and the sense of smell. Visual deterioration was associated with nyctalopia. Natural history revealed glaucoma 2а which was diagnosed when he was 48 years old. Best corrected visual acuity was 1,0. Peripheral visual field defects were revealed bilaterally. High visual acuity correlated with normal foveal structure on OCTs the retinal nerve fiber layer (RNFL) was thinner than normal in temporal half; deep excavation was visualized in both eyes. Normal MERG and bilateral decrease of scotopic, maximal full-field ERG was recorded which correlated with nyctalopia, as well as subnormal photopic responses indicating cone system involvement. The genetics revealed characteristic features of the face: a small nose with hypoplasia of the wings of the nose, unfolded nostrils and a wide bridge of the nose (pseudohypertelorism). On right-wing the ear sink was detected 2 antitraguses. Changes fingers upper extremities — operated syndactyly IV and V on the background of brachydactyly of the fingers. On the legs on both sides — syndactyly III–IV. 10 years the sense of smell has been dereriorated. In the study of DNA in proband in direct Sanger sequencing of all exons 1–2 and regions of exon-intron compounds of gene GJA1, was found the pathogenic variant in second exon c.412G&gt;A (p.Gly138Ser) in heterozygous state. Was established autosomal dominant type of disease.Conclusion. We are the first to describe rod-cone dystrophy in oculodental-digital dysplasia.

Agreement Between 10-2 and 24-2C Visual Field Test Protocols for Detecting Glaucomatous Central Visual Field Defects.

Moderate to substantial agreement between 10-2 and 24-2C perimetry for detecting central field defects suggests that adding central test points to the 24-2 protocol may improve efficiency of visual field (VF) testing for glaucoma management. The purpose of this study was to assess agreement between Humphrey Visual Field Analyzer 10-2 and 24-2C test protocols for detecting glaucomatous defects in the central 10 degrees of the visual field (CVFDs). VFs from 165 eyes of 18 healthy individuals, 12 glaucoma suspects and 62 glaucoma patients who completed 10-2 and 24-2C VF testing protocols within 6 months were included. CVFDs on 10-2 and 24-2C (within the central 22 points) test grids required a cluster of 3 contiguous points with P<5%, 5%, and 1% or <5%, 2%, and 2% within a hemifield on the total deviation (TD) or pattern deviation (PD) plot. Cohen kappa (k) was used to assess agreement between 10-2 and 24-2C test grids in identifying CVFDs. Specificity of each testing strategy was assessed in VFs from healthy eyes. CVFDs in suspect and glaucoma eyes were combined and reported as localized to superior, inferior or both hemifields based on TD and PD plots for 10-2 and 24-2C test grids. Moderate to substantial agreement was observed between 10-2 and 24-2C grids for detecting any CVFD from PD (k=0.551) and TD (k=0.651) plots. Specificity was high in healthy eyes ranging from 0.94 to 1.0 for both test protocols. Substantial agreement for identifying CVFDs using the 24-2C and 10-2 protocols suggests that combining tests by adding central test points to the 24-2 test grid may supplant the need for 2 perimetry regimens for detecting central and peripheral glaucomatous VF damage.

Portable Diagnostic System for Age-Related Macular Degeneration Screening Using Visual Evoked Potentials.

BackgroundDelayed Dark-Adapted vision Recovery (DAR) is a biomarker for Age-related Macular Degeneration (AMD), however its measurement is burdensome for patients and examiners.MethodsIn this study, we developed a portable, wireless and user-friendly system that employs a headset with a smartphone to deliver controlled photo-bleach and monocular pattern reversal stimuli, while using custom electroencephalography (EEG) electrodes and electronics in order to measure Dark-Adapted Visual Evoked Potentials (DAVEP) objectively and separately at the peripheral and central visual field. This is achieved in one comfortable 20-minute session, without requiring subject reporting. DAVEP responses post photo-bleach for up to 15 minutes were measured concurrently from both eyes in 12 AMD-patients, 1 degenerative myopia patient, and 8 controls who had no diagnosed macular vision loss.ResultsRobust positive polarity DAVEP responses were observed at 200–500 ms from stimulus onset to scotopic stimuli that have been seldom reported and analyzed previously. The amplitude recovery of the DAVEP response was significantly delayed in AMD patients as compared to controls. We developed DAVEP1 scores, a simple metric for DAR, which classified 90% of subject eyes correctly, indicating the presence of AMD in at least one eye of all pre-confirmed subjects with this diagnosis.ConclusionWe developed a user-friendly, portable VEP system and DAVEP1 metric, which show a high potential to identify DAR-deficits in AMD-patients. This novel technology could aid in early diagnosis of AMD.

Axenfeld\u2010Rieger syndrome combined with a foveal anomaly in a three\u2010generation family: a case report

BackgroundAxenfeld-Rieger syndrome (ARS) is a rare autosomal dominant eye disorder that can also affect other organs of the human body. The condition is primarily characterized by the anterior segmental abnormalities of the eye. Here, we present an observational case series of a three-generation family with ARS and unexpected foveal anomaly.Case presentationA 33-year-old woman was admitted to an Ophthalmology Clinic in Bialystok for left eye congenital cataract surgery. The patient (proband) was diagnosed with visual deterioration, multiple defects of iris, corectopia, displacement of the Schwalbe’s line, and phenotypic characteristics of ARS. A perimetric examination indicated peripheral visual field loss and signs typical for glaucoma. Based on the phenotypic symptoms and genetic test, the patient was diagnosed with Axenfeld Rieger Syndrome. However, the optical coherence tomography of the macula showed foveal anomaly (absence of the physiological pit), which is not typically associated with this genetic disorder. The patient’s family history revealed that her two daughters were undergoing treatment for congenital glaucoma, and one of the daughters also had foveal anomaly the same as her mother. Interestingly, an examination of the patient’s mother showed typical phenotypic features of ARS such as a defect of the iris, posterior embryotoxon, and coloboma, as well as foveal anomaly. A genetic test confirmed PITX2 mutation in both, proband’s two daughters and mother.ConclusionsThis study highlights the occurrence of ARS with unusual ophthalmic features such as foveal anomaly (absence of the physiological pit) in a three-generation family. Although ARS is known to represent the developmental defects of the anterior segment of the eye, it is very important to perform fundus evaluation to identify associated posterior segment anomalies that may affect visual acuity. The presence of ocular defects not typically associated with ARS suggests a wide spectrum of mutations within PITX2 gene which are required to identify in order to determine genotype- phenotype correlation in ARS affected individuals.

Clinical observations of acute onset of myopic optic neuropathy in a real-world setting.

To describe the clinical features of acute myopic onset of optic neuropathy and observe the effects of retrobulbar and systemic glucocorticoid therapy in a real-world setting. A retrospective observational case series included 18 patients with a clinical diagnosis of acute onset of myopic optic neuropathy in a real-world setting. While the patients were using retrobulbar and systemic glucocorticoid therapy, various imaging examination data were analysed, and the clinical features of myopic optic neuropathy were summarized for 6mo to 2y. The included group of patients with acute onset of myopic optic neuropathy consisted mostly of females (n=11). The visual field (VF) showed abnormalities in bilateral eyes, including the spread of physiological blind spots, central and paracentral dark spots, and centripetal peripheral VF reduction; but central vision with no subjective changes. The visual evoked potential (VEP) was abnormal in all eyes with vision loss. The best corrected visual acuity (BCVA) was improved from 1.04±0.63 to 0.47±0.57 (logMAR) after glucocorticoid treatment (P<0.05). In patients with a short course (within 1wk), recovery was fast and achieved the same BCVA as recorded before the onset within 6d. However, in patients with the long course (1 to 2wk), recovery was slow and did not achieve the BCVA recorded before the onset within 10d. The changes of intraocular pressure (IOP) were not obvious before and after treatment (18.68±5.30 vs 19.55±5.34 mm Hg, P>0.05). There was no recurrence during long-term follow-up observation. The acute onset of myopic optic neuropathy is characterized by BCVA and VF abnormalities in bilateral eyes. Retrobulbar and systemic glucocorticoid therapy is effective.

Visual Field Assessment in Hypertension Glaucoma

Aims: The aim of the work is to verify the necessity of full-field perimetry test in incipient glaucoma. Material and methods: The study included group of 16 incipient hypertension glaucoma (HTG group) patients without obvious changes in visual field and control group of 10 patients with normal ocular findings and value 1.0 of visual acuity. In both groups, full-field perimetry test was performed followed by a glaucoma perimetry test (rapid threshold strategy in both cases). Evaluated parameters were pattern defect (PD) and overall defect (OD) using Pearson’s correlation coefficient. Results: Strong correlation coefficient between PD (r = 0.74) and OD (r = 0.63) of both perimetry test were found in HTG group. Moderate correlation of PD (r = 0.54) and strong correlation of OD (r = 0.64) in control group. Conclusion: Results of the study shows, that expected changes of peripheral visual field will be recorded first in HTG group, but opposite is true. Perimetry glaucoma test is for incipient glaucoma sufficient to document the course and the examination of glaucoma disease.

Effects of simulated peripheral visual field loss on the static postural control in young healthy adults

BackgroundIntegration of visual, vestibular, and proprioceptive sensations contributes to postural control. People with peripheral visual field loss have serious postural instability. However, the directional specificity of postural stability and sensory reweighting caused by gradual peripheral visual field loss remain unclear. Research questionWhat are the effects of peripheral visual field loss on static postural control? MethodsFifteen healthy young adults participated in this study. The participants were asked to stand quietly on a foam surface. Three conditions of virtual visual field loss (90°, 45°, and 15°) were provided by a head-mounted display, and ground reaction forces were collected using a force plate to calculate the displacements of the center of pressure (COP). ResultsThe root mean square (RMS), mean velocity, and 95% ellipse area of COP displacements in the horizontal plane increased, and RMS in the anteroposterior (AP) direction was unchanged under the smallest visual field condition compared to the largest one. The power spectrum density of COP displacements in the low-frequency band was decreased and that in the medium-frequency band was increased in the AP direction. SignificanceDuring quiet standing of young healthy adults with peripheral visual field loss, increased peripheral visual field loss resulted in lower postural stability. Postural stability in the AP direction was maintained contrary to the functional sensitivity hypothesis. Peripheral visual field loss reduced the weighting of the visual input and increased that of the vestibular input in the AP direction to maintain equilibrium.

Gyrate atrophy of the choroid and retina

A 20-year-old high myope male was referred due to peripheral vision loss. Best-corrected visual acuity was 20/32 OD and 20/50 OS. On slit-lamp examination, mild bilateral posterior subcapsular cataract was...

31115 Perimetric resilience in the retina: spatial distribution of preserved peripheral visual field loci in retinitis pigmentosa

ABSTRACT IMPACT: We developed a novel semi-automated computational platform to quantify spatial characteristics of preserved peripheral visual field loci in retinitis pigmentosa. This work may inform future research on therapies to prevent visual field loss in retinitis pigmentosa and related diseases. OBJECTIVES/GOALS: Retinitis pigmentosa (RP) causes progressive and severe peripheral visual field (pVF) loss in some but not all patients. The characteristics of pVF in RP are incompletely understood. We developed a novel semi-automated computational platform to quantify the spatial characteristics of pVF. METHODS/STUDY POPULATION: We analyzed preserved pVF size and location in both eyes of RP patients using the Goldmann V4e isopter. We developed a custom algorithm in MATLAB to align and average the binary V4e isopter segmentations, and generated a two-dimensional probability map of the spatial distribution of preserved pVF loci along the radial and circumferential dimensions. To adjust for disease duration, cases were categorized by the time from self-reported symptom onset. Probability maps of pVF preservation were generated for categories of disease duration using unsupervised K-means clustering. Analyzing cases with longitudinal data, we identified loci of stable pVF over time. RESULTS/ANTICIPATED RESULTS: A total of 152 patients were included (N=304 eyes). The mean age was 46.7 years and 49.3% were male. Disease duration was categorized as &lt;20 years (N=72, 47.4%), 20-40 years (N=60, 39.5%), or &gt;40 years (N=20, 13.2%). Longitudinal data (3.2 -5.7 years of follow-up) were available in 65 patients (42.8%). Probability plots of preserved pVF loci in the cross-sectional dataset showed that the median percentage of preserved pVF loci were located between 50 ºand 80 ºeccentricity and between the 30 ºto 50 ºmeridians, with highly concordant inter-ocular symmetry. Probability plots in the longitudinal dataset showed that inferotemporal pVF loci were most likely to be preserved over time. DISCUSSION/SIGNIFICANCE OF FINDINGS: Semi-automated quantification of pVF loci is a useful platform to analyze spatial characteristics of the visual field in RP. Certain portions of the pVF may be relatively resistant to functional decline. Understanding the molecular basis of pVF resilience will inform further research on RP therapy.