Isolated Homonymous Hemianopia

Trobe, Jonathan D.; Lorber, Morris L.; Schlezinger, Nathan S.

doi:10.1001/archopht.1973.01000040379005

Cited by 90 publications

(45 citation statements)

References 7 publications

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“…To put our results into perspective, Trobe et al 14 reported that 18% of their 104 hemianopes (88% having vascular origin) improved. An even worse proportion of improvement was observed in another study comprising 55 patients (7% improved, 80% of all patients had vascular origin).…”

Section: Discussionmentioning

confidence: 82%

Intravenous Thrombolysis in Ischemic Stroke Patients With Isolated Homonymous Hemianopia

Strbian

Ahmed

Wahlgren

et al. 2012

Stroke

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on behalf of SITS InvestigatorsBackground and Purpose-Hemianopia can cause considerable disability. Only scarce data are available for ischemic stroke patients presenting with isolated homonymous hemianopia and being treated with intravenous thrombolysis. We analyzed outcome of such patients registered in the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR). Methods-The SITS-ISTR (nϭ45 079) was searched for patients who presented with isolated homonymous hemianopia.We identified 72 such patients. We report their baseline and demographic characteristics, radiological data, change in their National Institutes of Health Stroke Scale score within 7 days after thrombolysis, and their 3-month modified Rankin Scale (mRS) score. Univariate analysis of parameters associated with any improvement was performed. Hemianopia was assessed with perimetric examination. Results-Of 72 patients, 40 (56%) improved within 7 days after thrombolysis; 19 (26%) had full recovery. Those who improved had significantly lower systolic blood pressure before thrombolysis and were less often administered antiplatelet agents before index stroke. Infarction was visible on 24-hour computed tomography scan in 65% of patients who improved compared with 81.2% of those without improvement (Pϭ0.32). No symptomatic intracranial hemorrhage occurred in patients who improved compared with 1 (3.1%) patient in the nonimproved group (Pϭ0.08). Seventy-one percent of all patients had 3-month mRS score 0 to 2, and 51% had mRS score 0 to 1. Those who improved within 7 days had a significantly better 3-month outcome (median mRS [interquartile range], 0 [0 -1] vs 2 [1-2]). Conclusions-Relatively few ischemic stroke patients received thrombolysis because of isolated homonymous hemianopia. Thrombolysis seems to be safe in these patients. Of those treated, more than half improved and more than two-thirds had good outcome. (Stroke. 2012;43:2695-2698.)

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Section: Discussionmentioning

confidence: 82%

Intravenous Thrombolysis in Ischemic Stroke Patients With Isolated Homonymous Hemianopia

Strbian

Ahmed

Wahlgren

et al. 2012

Stroke

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“…19 An important finding in the present study was that almost half (48%) of the subjects with homonymous field defects did not report a history of stroke. Although a number of disease processes, such as tumor, trauma, infection, or congenital lesions, can cause homonymous visual field defects, 20 it is recognized that in 40% to 90% of patients with isolated homonymous visual field defects, the underlying cause is cerebrovascular ischemia in the territory of the posterior cerebral artery. 20 -22 We were able to confirm 7 head CT scan reports for the 25 subjects with homonymous visual field defects.…”

Section: Gilhotra Et Al Homonymous Visual Field Defects and Strokementioning

confidence: 99%

Homonymous Visual Field Defects and Stroke in an Older Population

Gilhotra

Mitchell

Healey

et al. 2002

Stroke

123

104

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, 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.

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“…30 Further reports state that most stroke related visual field loss is related to an occipital infarct. [31][32][33] One previous study showed that the removal of the striate cortex in a monkey resulted in the nearly complete loss of projection neurons in the corresponding region of the LGN within 12 weeks. 33 The subsequent TRD of the RGC occurred after the degeneration of the projection neurons of the LGN.…”

Section: Discussionmentioning

confidence: 99%

Long Term Transneuronal Retrograde Degeneration of the Retinal Ganglion Cells in Patients with Cerebral Infarction

Yıldız¹,

Yıldız²,

Acar³

et al. 2016

Turkiye Klinikleri J Ophthalmol

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The purpose of this study was to investigate the probable transneuronal retrograde degeneration (TRD) of the retinal ganglion cells (RGCs) in humans with cerebral infarction. In addition, the correlation between the laterality and severity of the retinal nerve fiber layer (RNFL) damage and other variables (laterality of hemispheric damage and arterial territory of the infarct) were analyzed. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Thirty consecutive patients were included. All of the subjects underwent complete ophthalmic examinations, including optical coherence tomography (OCT) and perimetry after diagnosis, and in the 6 th and 12 th months. The main outcome measures were the changes in the thicknesses of the RNFL, RGCs, and visual field (VF). The average thickness of the total macular RGCs and MD and PSD values analyzed in the perimetry (using the SITA Standard 24-2 Threshold Test) were taken into account. R Re es su ul lt ts s: : The RNFL thicknesses were reduced significantly in all four quadrants in the contralateral eyes, and in the superior, inferior, and temporal quadrants in the ipsilateral eyes at 12 months. However, the reduction of the RGCs' average total thickness was not statistically significant for either the ipsilateral or contralateral groups (p>0.05). The loss of the VF considering the mean MD measurements was statistically significant in the contralateral group (p=0.001) unlike in the ipsilateral group. C Co on nc cl lu us si io on ns s: : The RNFL thickness was reduced in both eyes at 12 months, providing evidence for TRD. The TRD was more pronounced in the nasal quadrant of the contralateral and temporal quadrant of the ipsilateral eye.K Ke ey y W Wo or rd ds s: : Brain infarction; retrograde degeneration; optic nerve; retinal ganglion cells; visual field tests Ö ÖZ ZE ET T A Am ma aç ç: : Çalışmanın amacı serebral infarkt hastalarında retinal ganglion hücrelerinin (RGH) olası transnöronal retrograde dejenerasyonunu (TRD) araştırmaktır. Retinal sinir lifi (RNFL) hasarının ciddiyeti ve tarafı ile diğer değişkenlerin arasındaki ilişkinin yanı sıra hemisferik hasarın tarafı ve infarkta sebep olan arter bölgesi de analiz edildi. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Otuz ardışık hasta çalışmaya dahil edildi. Tüm hastalar tanı aldıktan sonra optik koherens tomografi (OKT) ve perimetriyi de içeren tam bir oftalmik muayeneden geçirildi ve tetkikler 6. ve 12. aylarda tekrarlandı. Çalışmanın ana amacı RSLT ve RGH tabakalarındaki kalınlık değişimleri ile görme alanındaki değişimleri değerlendirmekti. Ortalama total maküler RGH kalınlığı ve perimetri (SITA-Standart 24-2 eşik test) MD, PSD değerleri dikkate alındı. B Bu ul lg gu ul la ar r: : On ikinci ayda RSLT; kontralateral gözde dört kadranda; ipsilateral gözde ise superior, inferior ve temporal kadranlarda anlamlı derecede incelmiş idi. Ortalama total maküler RGH tabakasındaki incelme ipsilateral ve kontralateral göz için istatistiksel olarak anlamlı değil...

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Isolated Homonymous Hemianopia

Cited by 90 publications

References 7 publications

Intravenous Thrombolysis in Ischemic Stroke Patients With Isolated Homonymous Hemianopia

Intravenous Thrombolysis in Ischemic Stroke Patients With Isolated Homonymous Hemianopia

Homonymous Visual Field Defects and Stroke in an Older Population

Long Term Transneuronal Retrograde Degeneration of the Retinal Ganglion Cells in Patients with Cerebral Infarction

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