Homonymous Visual Field Defects and Stroke in an Older Population

Abstract

, MBBS, FRACPPurpose-The objective of the present study was to describe the prevalence of homonymous visual field defects in a defined older urban population and associations with self-reported stroke. Methods-Homonymous visual field defects were assessed from screening automated visual field tests of both eyes in 3654 persons aged Ն49 years who were participating in the Blue Mountains Eye Study. This represented 82.4% of eligible residents from a defined area west of Sydney, Australia. A detailed eye examination was performed, and the medical history was taken. Masked grading of visual fields was used to classify the presence of homonymous visual field defects. Results-Homonymous visual field defects were found in 25 persons (prevalence 0.8%, 95% CI 0.5% to 1.1%). Stroke history was reported by 194 participants (5.3%, 95% CI 4.6% to 6.1%). A strong relationship was found between homonymous visual field defects and history of stroke, age-, and sex-adjusted odds ratio (OR) 23.4 (95% CI 9.9 to 55.7). Homonymous field defects were present in 8.3% of all persons who reported experiencing a stroke. Among those with homonymous field defects, 52% reported a history of stroke. Only 2 of 10 persons (20%) with homonymous field defects without a history of stroke reported having stopped driving, whereas 6 of 9 (67%) reporting stroke had stopped driving (Pϭ0.07). Increasing age (OR 1.4 per decade, 95% CI 1.2 to 1.8) was significantly associated with homonymous visual field defects, with adjustment for sex, whereas a history of hypertension (OR 2.7, 95% CI 1.2 to 6.1), diabetes (OR 2.1, 95% CI 1.4 to 3.2), and renal impairment (OR 2.8, 95% CI 1.0 to 8.1) also was associated, with adjustment for age and sex. Conclusions-This study provides accurate prevalence data for homonymous visual field defects in an older population.About half the participants did not report stroke.

Macular ganglion cell–inner plexiform layer thinning in patients with visual field defect that respects the vertical meridian

“…Incomplete HH is defined as a homonymous VF defect that respects the vertical meridian with some normal VF in the affected hemifield, this can include HH with macular sparing, partial HH, homonymous quadrantanopia, homonymous scotomatous defects, homonymous sectoranopia, and unilateral loss of the temporal crescent [9]. In one study, 11 of 12 patients with HH who continued to drive had incomplete HH [11]. This suggests that incomplete HH does not severely affect the activities of daily life and sometimes can be overlooked.…”

Efficacy and Feasibility of Home-Based Training for Individuals With Homonymous Visual Field Defects

“…Homonymous visual field defects (HVFDs) are one of the most frequent consequences of brain injury [1][2][3] . Hemianopia (blindness in half the visual field) is the most common, followed by quadrantanopia (blindness in one quarter of the visual field) 4 .…”

A Rare Complication After Conventional Coronary Angiography: Left Homonymous Hemianopia

“…Tumor, trauma, infections, and congenital factors are other etiological factors. Still, 40-90% of the VFL occur as a result of cerebral artery infarcts (7). HH might recover spontaneously, although most of the cases resolve with sequels.…”

“…Hemianopsia constitutes 70% of all visual field loss that occur in the cerebral artery infarcts (6). Homonymous visual field defects occur in approximately 8% patients who have experienced a stroke (7). It was shown that the risk of cerebral embolism is higher when CAG is done via the radial artery when compared to the femoral artery.…”