Prevalence Of Visual Field Defects Research Articles

24-2 Visual Fields Miss Central Defects Shown on 10-2 Tests in Glaucoma Suspects, Ocular Hypertensives, and Early Glaucoma

To investigate the prevalence of visual field defects in glaucomatous eyes, glaucoma suspects, and ocular hypertensives with 24-2 and 10-2 visual fields. Prospective, cross-sectional study. Patients with or suspected glaucoma tested with 24-2 and 10-2. Patients were classified into 3 groups on the basis of the presence of glaucomatous optic neuropathy (GON) and 24-2 visual field abnormalities: early glaucoma (GON and abnormal visual field, mean deviation >-6 decibels [dB]), glaucoma suspects (GON and normal visual field), and ocular hypertensives (normal disc, normal visual field, and intraocular pressure >22 mmHg). For the classification of visual field abnormalities, 24-2 and 10-2 tests performed on the same visit were analyzed. Comparison of the prevalence of abnormal 24-2 versus 10-2 visual field results based on cluster criteria in each diagnostic group. A total of 775 eyes (497 patients) were evaluated. A total of 364 eyes had early glaucoma, 303 eyes were glaucoma suspects, and 108 eyes were ocular hypertensives. In the glaucoma group, 16 of the 26 eyes (61.5%) classified as normal based on cluster criteria on 24-2 tests were classified as abnormal on 10-2 visual fields. In eyes with suspected glaucoma, 79 of the 200 eyes (39.5%) classified as normal on the 24-2 test were classified as abnormal on 10-2 visual fields. In ocular hypertensive eyes, 28 of the 79 eyes (35.4%) classified as normal on the 24-2 were classified as abnormal on the 10-2. Patients of African descent were more likely to have an abnormal 10-2 result (67.3 vs. 56.8%, P= 0.009). Central visual field damage seen on the 10-2 test is often missed with the 24-2 strategy in all groups.This finding has implications for the diagnosis of glaucoma and classification of severity.

Vigabatrin versus carbamazepine monotherapy for epilepsy.

This is an update of a Cochrane review first published in 2012 (Cochrane Database of Systematic Reviews 2012, Issue 1).The efficacy and safety of vigabatrin (VGB) as an add-on therapy for refractory epilepsy have been well established. However, this information needs to be weighed against the risk of development of visual field defects. Whether VGB monotherapy is an effective and safe treatment compared with the standard antiepileptic drug carbamazepine (CBZ) as monotherapy for epilepsy has not been systematically reviewed. To investigate the efficacy and safety of VGB versus CBZ monotherapy for epilepsy in children and adults. For the latest update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3 of 4), MEDLINE (1948 to July 2015), EMBASE (1974 to July 2015) and the Chinese Biomedical Database (CBM) (1979 to July 2015). We searched trial registers and contacted themanufacturer of VGB and authors of included studies for additional information. We applied no language restrictions. Randomised controlled trials (RCTs) comparing VGB versus CBZ monotherapy for epilepsy. Two review authors independently assessed trial quality and extracted data. The primary outcome was time to treatment withdrawal. Secondary outcomes were time to achieve six-month and 12-month remission after randomisation, time to first seizure after randomisation and adverse events. We presented results as hazard ratios (HRs) with 95% confidence intervals (CIs) (time to event data) or as risk ratios (RRs) with 95% CIs (adverse events). Five studies involving a total of 734 participants were eligible for inclusion. We assessed only one study as good quality and the other four as poor quality. However, it was difficult to perform a meta-analysis by extracting aggregate data to synthesise the results as originally planned, mainly because not all studies reported the same outcomes as those chosen for this review. No significant differences favoured VGB or CBZ in terms of time to treatment withdrawal and time to achieve six-month remission after dose stabilisation from randomisation, but results did show a disadvantage for VGB on time to first seizure after randomisation. Compared with CBZ, VGB was associated with more occurrences of weight gain and fewer occurrences of skin rash and drowsiness. No differences in visual field defects and visual disturbances were noted. Data are currently insufficient to address the risk-benefit balance of VGB versus CBZ monotherapy for epilepsy. Given the high prevalence of visual field defects reported in an existing systematic review of observational studies (Maguire 2010), VGB monotherapy should be prescribed with caution for epilepsy and should not be considered a first-line choice. If necessary, the visual field should be frequently assessed. Future research should focus on investigating the reasons for visual field defects and exploring potential prevention strategies. Moreover, future monotherapy studies of epilepsy should report results according to the recommendations of the International League Against Epilepsy (ILAE) Commission, and methodological quality should be improved.

Manejo optométrico de baja visión asociada a macroadenoma hipofisiario

<p>El macroadenoma hipofisiario es un tumor de diámetro superior a 10 mm ubicado en la hipófisis, con una prevalencia del 0,20 % en población viva no seleccionada. Las manifestaciones clínicas incluyen alteraciones visuales tales como defectos en el campo visual (CV) debidos al desplazamiento del quiasma óptico de su posición inicial. La prevalencia de los defectos del CV varía del 32 % al 96 % y generalmente se encuentra hemianopsia bitemporal. Estos pacientes raramente se manejan de manera itegral y son considerados como pacientes con baja visión según la OMS. De aquí la importancia del conocimiento del manejo optpmétrico integral en estos casos</p>

Expanding Treatment Options for Cocaine Dependence

Expanding Treatment Options for Cocaine Dependence

Automated static perimetry: the influence of myopia and its method of correction

Objective To determine how the magnitude of myopia and its method of correction influence visual field testing. Design Prospective observational case series, including comparison of spectacles and contact lenses. Participants One hundred forty-six ophthalmologically normal males 19 to 24 years of age with myopia (spherical equivalent from −0.50 to −14.0 diopters). Methods Participants performed automated static threshold perimetry. Refractive errors were corrected using trial lenses and soft contact lenses. Subjects were tested with both methods of correction, the order of which was randomized. Main outcome measures Threshold sensitivity and global indexes. Results Only one subject (0.7%) had a significant reproducible visual field defect on both methods of correction. Six subjects (4.1%) had a focal visual field defect on one method of correction but not the other. For myopia greater than −4.0 diopters, the mean defect decreased significantly as axial length and degree of myopia increased ( P < 0.01). Similar results were obtained with either method of correction. Conclusions Threshold sensitivity is reduced in moderate and high myopia, regardless of the method of correction. The surprisingly low prevalence of visual field defects in this myopic population disputes the widely held view that myopia is associated commonly with visual field abnormalities. If field defects are found in myopes on automated perimetry, it is advisable to repeat the test with another method of optical correction to check that such defects are genuine and not related to the method of refractive correction.

Alteraciones de los campos visuales secundarias al tratamiento con vigabatrina

Vigabatrin is an effective antiepileptic drug for treatment of partial crises with or without generalization. It acts by increasing GABA levels by irreversible inhibition of the enzyme GABA-transaminase. In recent years there have been several reports published on the appearance of alterations of the visual fields of patients treated with this drug. To study the prevalence and characteristics of the visual field changes associated with vigabatrin treatment in an adult epilepsy clinic. Ophthalmological examination, consisting of questions about eye symptoms, study of the fundus oculi, Humphrey-type campimetry, protocol 30-2, visual evoked potentials and electroretinogram were done on a group of 10 patients on long-term vigabatrin treatment. Six of the ten patients (60%) had campimetric alterations, which were serious in two cases (20%). Only the two patients with severe field defects complained of sight changes when questioned and their complaints were mainly of repeatedly bumping into things. In two patients (20%) there was pallor of the optic nerve. In both cases, the patients with severe field defects showed alterations on the electroretinogram. Visual evoked potentials were normal in all cases. There is a very high prevalence of visual field defects in patients on long-term treatment with vigabatrin. Clinical ophthalmological signs are not usually seen until advanced stages. Pallor of the optic nerve was seen in a group of patients. It is very important that serial campimetric studies are done for early detection of such alterations.

Visual field defects associated with vigabatrin therapy

OBJECTIVETo estimate the prevalence of visual field defects in patients taking the anticonvulsant drug vigabatrin and to characterise the features of visual dysfunction found.METHODSThirty three unselected patients attending neurology and...

Normal visual fields as assessed by computerized static threshold perimetry in patients with untreated primary hypothyroidism.

In this prospective study, 25 consecutive patients with untreated primary hypothyroidism were tested with a highly sensitive perimetric technique, since a high prevalence of visual field defects has been described in this condition. All patients had clinical hypothyroidism, a serum TSH value greater than 20 mU/l (reference range 0.4-4.0) and decreased/low normal serum total T4 concentration. Visual fields were tested with fully automated threshold-measuring computerized perimetry of the central 30 degrees field. Interpretation of fields included computer-assisted analysis provided by a perimetric statistical programme package. In 23 patients, conventional inspection and computer-assisted analysis showed no visual field defects. Two patients were excluded from the latter analysis: one patient who did not respond adequately at computerized perimetry and in whom manual field tests were entirely normal: one patient who had low sensitivity values in the uppermost parts of both visual fields owing to markedly swollen upper eye lids. In conclusion, although pituitary hyperplasia has been well documented in primary hypothyroidism, the present prospective study clearly indicates that visual field defects are not a common finding in patients with this disease.