A comparative study of vision-related quality of life (VRQoL) among glaucoma and nonglaucoma patients at a tertiary care center of North India

Purpose: Glaucoma influences vision?related quality of life (VRQoL) of an individual in various ways. There are very limited studies on the Indian population and the northern part of India. Therefore, we conducted the present study to evaluate VRQoL in glaucoma patients as well as the association between the severity of glaucoma and VRQoL. Methods: An institution?based, cross?sectional, analytical study was conducted from August 2022 to October 2022 involving 190 participants (95 glaucoma patients and 95 controls). The glaucoma quality of life?15 (GQL?15) questionnaire was explained in their vernacular language by the interviewer. The scoring was given according to the validated scoring algorithm for the questionnaire. Results: Mean GQL score in the control group was 19.66 ± 5.5 and in glaucoma cases was 32.8 ± 10.2, whereas the mean score of mild glaucoma cases was 22.3 ± 4.83, moderate glaucoma cases was 36.3 ± 4.09, and severe glaucoma cases was 47.24 ± 3.03. Therefore, as the severity of glaucoma increases, the GQL score also increases, indicating poorer quality of life. Visual field loss was strongly positively correlated (correlation coefficient = 0.759, P < 0.01) with the GQL?15 score, while a weaker positive correlation was found with best corrected visual acuity (BCVA), cup disc ratio, and duration of treatment. Conclusion: Besides controlling or reducing intraocular pressure (IOP) to the target level, the goal of glaucoma treatment should be to provide an individual with good functional vision to maintain an acceptable quality of life. It would also help in providing patients with the best possible treatment, not only in terms of good vision but also in maintaining or improving their overall quality of life.

Advances in transsynaptic retrograde degeneration of optic neuropathy / 中华眼底病杂志

Transsynaptic retrograde degeneration of optic neuropathy (TRDON) refers to the degeneration and/or apoptosis of presynaptic neurons (retinal ganglion cells) caused by damage to the lateral geniculate body and post-geniculate visual pathway. At present, the pathogenesis of TRDON is secondary apoptosis of P β-type retinal ganglion cells, resulting in the atrophy of optic tract, thinning of the retinal nerve fiber layer and retinal ganglion cell layer thickness and declining of retinal microvascular density, which are consistent with the visual field defect attributed to the primary disease. Of which, the thinning of the retinal ganglion cell layer thickness is considered as the characteristic of TRDON. Now, there is little understanding and related research on TRDON in China. Clinicians should pay attention to the characteristics and severity, occurrence time and location of the above structural changes in these patients through optical coherence tomography, and monitor the activity and progress of the lesions, so as to determine the cut-off point for drug intervention and the drug targets for developing new treatment methods, and bring benefits for patients in partial visual function recovery and disability reduction.

Relationship between blood vessel density in optic disc area and visual field index and visual field defect morphology in patients with normal tension glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the relationship between the changes of blood vessel density in optic disc area of normal tension glaucoma(NTG)and visual field index(VFI)of glaucoma and morphological staging of visual field defect. <p>METHODS: Totally 106 patients(106 eyes)with NTG and 79 patients(79 eyes)with primary open angle glaucoma(POAG)in the hospital between December 2018 and December 2020 were selected for cross-sectional study. Among them, 1 eye of binocular disease was selected as the sample by the random number table method, and another 92 healthy subjects with physical examination in the hospital were selected as control group. All three groups completed the optic disc blood vessel density, VFI detection and visual field defect morphological staging, and the relationship between optic disc blood vessel density and VFI and visual field defect morphological staging were analyzed.<p>RESULTS: The intraocular pressure in POAG group was significantly higher than that in NTG group and control group(<i>P</i><0.05). The whole optic disc area blood vessel density, large vessel density and capillary density of NTG group and POAG group were significantly lower than those of control group(<i>P</i><0.05)while the density of avascular area was significantly higher than that of control group(<i>P</i><0.05), and there were differences in various indicators between NTG group and POAG group(<i>P</i><0.05). The VFI of NTG group and POAG group was significantly lower than that of control group(<i>P</i><0.05)while the mean visual field defect(MD)was significantly higher than that of control group(<i>P</i><0.05), and there were no statistical differences in VFI and MD between NTG group and POAG group(<i>P</i>>0.05). With the increase in visual field defect morphology staging, the whole optic disc area blood vessel density and capillary density of patients with NTG showed a significant decrease(<i>P</i><0.05). The whole optic disc area blood vessel density and capillary density of patients with NTG were positively correlated with VFI and negatively correlated with visual field defect staging, and avascular area density was negatively correlated with VFI and positively correlated with visual field defect staging(all <i>P</i><0.05). <p>CONCLUSION:Optic disc blood vessel density of patients with NTG is significantly lower than that of patients with POAG and normal people, and it is significantly correlated with VFI and visual field defect morphological staging. Among them, capillary density has the highest correlation. It can be seen that OCTA has important clinical significance for NTG diagnosis, treatment and follow-up.

Follow-up study on factors related to visual field progression of the primary open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the related factors of visual field progression in patients with primary open angle glaucoma(POAG), and to provide novel ideas for more accurate and efficient follow-up of clinical patients. <p>METHODS: A prospective study that includes thirty-nine patients(77 eyes)with POAG who were followed up every three months for 7 consecutive times. After inquiring the history in detail, intraocular pressure(IOP), visual field examination and nerve fiber layer(RNFL)thickness were measured. During follow-up the family history, smoking and drinking history, age, gender, surgery, IOP fluctuation, baseline visual field defect and RNFL thickness change were analyzed.<p>RESULTS: During the follow-up period, the degree of RNFL thinning was positively correlated with visual field progression(<i>P</i><0.05). The baseline visual field defect was associated with visual field progression. Moderate baseline visual field defect has the greatest correlation with the progression of visual field damage, the second is mild, and the least is severe.<p>CONCLUSION: Changes in RNFL thickness may provide useful information and progressive judgment of patients with mild and severe visual field defects should be combined with other information besides visual field.

Advances in the application of portable perimetry in glaucoma / 中华实验眼科杂志

Glaucoma is the irreversible blind eye disease and many glaucoma patients have severe optic nerve and visual field defect in their initial diagnosis.Therefore,visual field is critical to the evaluation of glaucoma damage.However,the testing time is too long and the conventional standard automatic perimetry is not convenient to carry,which limits its application in the diagnosis of glaucoma.At present,a variety of portable perimetries and softwares have been developed,and its rapid,effective and portable features are convenient for the diagnosis of glaucoma.This article summarized the advances in the application of various portable perimetry,which have been used to evaluate the glaucomaous visual field defect.

Effects of monocular visual field injury on binocular visual field in patients with glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the effect of the severity of monocular visual field loss on binocular visual field loss patients with primary angle-closure glaucoma, primary open angle glaucoma and normal tension glaucoma. <p>METHODS: According to the stage of binocular monocular field loss, 30 healthy and 120 glaucoma patients participants were classified as normal, early, moderate or severe. Binocular vision was determined by integrating the field of view and Esterman binocular field assessment. The monocular and binocular visual field parameters were compared within and between groups. <p>RESULTS:For patients with one eye at normal or early stage and the other with severe stage, the mean deviation of binocular comprehensive visual field was -2.8±1.1dB and -5.5±1.9dB, respectively, and Esterman's average score were 99.1%±1.7% and 95.6%±4.7%, respectively. When both eyes developed moderate or severe injury(moderate/moderate, moderate/severe or severe/severe), the mean deviation of binocular comprehensive visual field is lower than -6dB, and the Esterman average score of moderate/moderate group and moderate/severe group was 94.2%±6.0% and 94.3%±4.9%, respectively. However, when both eyes in the stage of severe injury, the average score of Esterman's rapidly decreased from more than 90% to 68.4%±26.3%.<p>CONCLUSION: If one eye is in a normal or early stage, the binocular vision can remain relatively intact. When the binocular progression to the moderate or severe stage, the mean deviation of binocular visual field defects measured by the binocular comprehensive visual field is significant, and only when the binocular progression to the severe stage, significant Esterman binocular visual field defects are detected.

Analysis of cardiovascular risk factors and visual function in nonarteritic anterior ischemic optic neuropathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of cardiovascular risk factors on the occurrence of nonarteritic anterior ischemic optic neuropathy(NAION)and visual functions of the patients.<p>METHODS: Sixty-eight patients diagnosed as initial ipsilateral NAION(68 eyes)in NAION group and another 68 patients(68 eyes)matched in age, gender and systemic diseases in Control group were selected from June 2014 to June 2016 were enrolled in this study and evaluated for their levels of homocysteine(Hcy), blood lipids, folic acid and vitamin B12, as well as carotid Doppler ultrasonography. The visual functions were also examined in patients with NAION.<p>RESULTS: The levels of Hcy(24.8±13.9μmol/L), total plasma cholesterol(4.5±1.0mmol/L), triglyceride(2.0±0.9 mmol/L)and low-density lipoprotein(2.9±0.8mmol/L)in NAION patients were significantly higher(<i>P</i><0.05)than those in Control group(11.1±8.2μmol/L, 3.8±0.7mmol/L, 1.5±0.5mmol/L and 2.3±0.5mmol/L)while the level of vitamin B12 decreased significantly(315.6 ±214.5pg/mL, <i>P</i><0.05)in NAION group in comparison with those(467.9±198.2pg/mL)in Control group. However, no significant differences in the artery resistance and inner diameter of the internal carotid were detected between the two groups. The mean deviation(MD)of the visual field was 16.6±7.5dB in NAION group. The levels of Hcy, vitamin B12, folic acid and blood lipid and the presence of systemic diseases were not the risk factors for the visual field damage in NAION patients. MD value was associated with the amplitude and peak latency of P100 waves.<p>CONCLUSION: Hyperhomocysteinemia, hyperlipidemia and low vitamin B12 are the risk factors of in NAION patients. These risk factors, however, are not related to the extent of visual field damage. To some extent, the amplitude and peak latency of visual evoked potentials can reflect the extent of visual field damage.

Visual Field Defect after Taking Atorvastatin/Ezetimibe, a Case Study

Atorvastatin is one of the most widely prescribed medications for dyslipidemia treatment. In Korea, post combined therapy with ezetimibe, a 73-year-old woman was reported by a community pharmacy to have experienced visual field defect, which recovered after drug discontinuation. She had never experienced this symptom before, and several studies have reported an association between use of statins and visual disorders such as blurred vision, diplopia, and cataract. Blockage of cholesterol accumulation, oxidative stress, or myopathy is expected to be a cause of this symptom. Naranjo scale, Korean causality assessment algorithm (Ver.2), and World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria were the three tools used to determine causality between the visual disorder and atorvastatin. The results represent ‘probable’, ‘certain’, and ‘probable/likely’ causality, respectively. Our results, in combination with a review of literature, indicate that ocular adverse effects are highly likely related to atorvastatin.

Visual Field Changes after Internal Limiting Membrane Peeling in Glaucoma Patients with Epiretinal Membrane

PURPOSE: To report visual field changes after internal limiting membrane (ILM) peeling for macular epiretinal membrane (ERM) according to the severity of glaucoma. METHODS: A retrospective review of 37 eyes from 37 patients who underwent ILM peeling to treat ERM. Standard automated perimetry (Humphrey visual field 24-2 program) was performed preoperatively and postoperatively. Based on the Advanced Glaucoma Intervention Study (AGIS) scoring system of preoperative visual field, patients were classified into the early glaucoma (AGIS ≤ 1) group or the advanced glaucoma (AGIS ≥ 2) group. Postoperative visual field sensitivity at each point was compared with the preoperative value. RESULTS: Out of 37 eyes, 15 eyes had early glaucoma and 22 had advanced glaucoma. Eyes from both groups had poor postoperative visual field parameters. For eyes with advanced glaucoma, the visual field index was significantly reduced and the visual field damage was larger and wider compared to those with early glaucoma. In both groups, visual field impairment was greater on the nasal side than on the temporal side, and visual acuity was not significantly different. Postoperatively, the macular ganglion cell-inner plexiform layer thickness was decreased, especially on the temporal side of advanced glaucoma. CONCLUSIONS: Visual field impairment was greater and wider in eyes with advanced glaucoma than in those with early glaucoma after ILM peeling in patients with ERM.

A Case of a Visual Field Defect with Optical Coherence Tomography Changes after Sildenafil Citrate Overdose

PURPOSE: A case of a transient visual field defect and a change in spectral-domain optical coherence tomography (SD-OCT) after an overdose of sildenafil citrate is described. CASE SUMMARY: A 67-year-old male with no previous medical history presented with a bluish tinge and visual field defect in both eyes. He had consumed eight tablets of sildenafil citrate (800 mg) 3 days before the visit. His best-corrected visual acuity was 14/20 in the right eye and 20/20 in the left eye. No specific finding was noted on slit-lamp examination. Fundus examination and fundus photography revealed focal foveal hypopigmentation in both eyes. He underwent SD-OCT imaging with the Cirrus HD-OCT (Carl Zeiss Meditec, Oberkochen, Germany), and thickening of the ellipsoid zone and choroid was revealed by SD-OCT scans. He was advised not to take any more sildenafil citrate and was followed for 1 week after the first visit. Central scotomas of both eyes were revealed by a visual field test, and thickening of the ellipsoid zone and choroid remained. His eyes were re-evaluated 1 and 3 months after the first visit, and although the symptoms nearly disappeared, abnormalities in the visual field test and on SD-OCT remained, albeit with some degree of improvement. He revisited us 4 months after the first visit, at which time the visual field test and SD-OCT scans showed results within normal ranges. CONCLUSIONS: Sildenafil citrate overdose can result in a color anomaly (bluish tinge), visual field defects, and thickening of the ellipsoid zone and choroid on SD-OCT scans.

Application of EDI-OCT in measuring the plate thickness in patients with branch retinal vein occlusion / 眼科新进展

Objective To analyze the application value of enhanced depth imaging optical coherence tomography (EDI-OCT) in measuring the lamina cribrosa thickness(LCT) in patients with branch retinal vein occlusion (BRVO).Methods The clinical data of 65 patients with unilateral BRVO treated in our hospital from September 2014 to March 2016 were selected as the observation group.The single healthy eyes of 40 healthy individuals who received physical examination in the hospital during the same period were selected as the control group.The changes of retinal nerve fiber layer (RNFL) thickness,LCT,central corneal thickness,axial length,transverse diameter of optic disc,vertical diameter of optic disc,diopter and extent of visual field defect in the two groups were determined by EDI-OCT.Results There was no significant difference in the central corneal thickness,axial length,transverse diameter of optic disc,vertical diameter of optic disc and diopter between the two groups (all P ＞ 0.05).LCT of different regions of optic disc in the observation group were lower than those in the control group (all P ＜ 0.05).The range of visual field defects in the observation group was larger than that in the control group,and the RNFL thickness was lower than that in the control group (P ＜ 0.05).LCT was positively correlated with the thickness of whole RNFL in patients with BRVO,and was negatively correlated with the visual field defects (P ＜ 0.05).Conclusion EDI-OCT is an effective means for measuring LCT.LCT of patients with glaucoma BRVO is thinner than that of normal healthy people,and LCT is positively correlated with RNFL.thickness,and negatively correlated with visual field defects.

Application of retinal nerve fiber layer thickness detected by OCT in the diagnosis of primary open angle glaucoma and its relationship with mean defect of visual field / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the application of retinal nerve fiber layer (RNFL) thickness detected by OCT in the diagnosis of primary open angle glaucoma (POAG) and its relationship with the mean defect of visual field.METHODS:A retrospective study was carried out.Totally 158 cases (158 eyes) of patients with POAG were selected as POAG group, including 81 cases in early stage, 47 cases in middle stage and 30 cases in late stage.At the same time, 50 cases of persons without eye related diseases were selected as the control group.The upper, lower, nasal and bitamporal RNFL thickness and mean defect of visual field were detected, and the patients with POAG were followed up for 3mo.RESULTS:The upper, lower, nasal and bitamporal RNFL in POAG group were thinner than those in the control, and the mean defect of visual field was higher than that in the control group at different time (P0.05).The RNFL thickness of various parts was higher than that in patients with middle and late POAG, and the mean defect of visual field was lower than that in patients with middle and late POAG (P0.05).Pearson correlation analysis showed that the upper, lower, nasal and bitamporal RNFL thickness was negatively correlated with the mean defect of visual field (r=-0.719,-0.615,-0.681,-0.518, P<0.05).CONCLUSION:OCT can monitor the change of RNFL thickness in patients with POAG, and has a negative correlation with mean defect of visual field, which can be used for early diagnosis of POAG.

A Case Report of Occipital Lobe Epilepsy and Related Optical Coherence Tomography Findings

PURPOSE: In the present case report, visual pathway damage confirmed by retinal ganglion cell layer (GCL) damage on optical coherence tomography (OCT) in occipital lobe epilepsy was described. CASE SUMMARY: A 25-year-old female with idiopathic generalized epilepsy developed visual blurring followed by a generalized seizure. On brain magnetic resonance imaging (MRI), very subtle changes of the cortex in the left parietooccipital lobe were observed. Two days after the attack, even after the disappearance of epileptiform wave on electroencephalogram (EEG), visual acuity in both eyes was 0.5 and a perimetry revealed nearly complete visual defect in both eyes. OCT showed severe thinning of GCL and mild thinning of retinal nerve fiber layer (RNFL). No additional seizure attack occurred thereafter. One month after the attack, her visual acuity was recovered to 1.0 in both eyes and her left visual hemifield defect was recovered. However, even 6 months after the attack, her right visual hemifield defect and GCL damage persisted in both eyes. CONCLUSIONS: We reported a case in which the visual pathway damage caused by occipital lobe epilepsy was identified using OCT, despite very subtle changes in brain imaging. This case indicated GCL thinning is an objective and prognostic index for the irreversible visual field defect in occipital lobe epilepsy.

Effect of calcium dobesilate combined with compound Xueshuantong in patients with diabetic retinopathy / 中国生化药物杂志

Objective To explore the clinical effects of calium dobesilate combined with compound thrombosis for patients with diabetic retinopathy due to visual field defect.Methods 112 cases of patients with diabetic retinopathy from February 2014 to February 2016 in our hospital were selected and randomly divided into the observation group and the control group,56 cases in each group.The control group were given compound Xueshuantong, while the observation group were treated with calcium dobesilate orally.And both the two groups were treated for five months.The hemangioma volume , macular thickness, hemorrhagic spot area, visual gray value, visual acuity, CRP, VEGF and IGF-1 levels in two groups were measured before and after treatment, as well as the clinical efficacy and adverse effects during the treatment.Results The total effective rate in the observation group was 94.6%significantly higher than that in the control group 71.4% (P<0.05).After treatment, in the two groups the hemangioma volume, macular thickness, hemorrhagic spot area, visual field gray value, visual acuity and 30°threshold sensitivity were significantly improved (P<0.05),but the improvement in the observation group was more (P<0.05).After treatment, the levels of hs-CRP, VEGF and IGF-1 were all significantly decreased (P<0.05), but the observation group decreased more significantly (P<0.05).Adverse reactions were mainly gastrointestinal reactions, and the incidence of adverse reactions in the two groups had no statistically significant difference.Couclusion Calcium dobesilate combined with compound thrombosis for patients with diabetic retinopathy due to visual field defect can improve the visual field defect of diabetic retinopathy patients.Its clinical effects is better and the safety is higher, which mechanism may be related to reducing the level of inflammatory factors in patients.

Rapid Visual Deterioration Caused by Posterior Fossa Arachnoid Cyst

Posterior fossa is a site next to the middle fossa where arachnoid cyst frequently occurs. Generally, most arachnoid cysts are asymptomatic and are found incidentally in most cases. Although arachnoid cysts are benign and asymptomatic lesions, patients with posterior fossa arachnoid cysts often complain of headaches, gait disturbance, and ataxia due to the local mass effects on the cerebellum. We observed a patient with a posterior fossa arachnoid cyst who had visual symptoms and a headache, but did not have gait disturbance and ataxia. We recommended an emergency operation for decompression, but the patient refused for personal reasons. After 7 days, the patient revisited our hospital in a state of near-blindness. We suspected that the arachnoid cyst induced the hydrocephalus and thereby the enlarged third ventricle directly compressed optic nerves. Compressed optic nerves were rapidly aggravated during the critical seven days; consequently, the patient's vision was damaged despite the operation. Considering the results of our case, it is important to keep in mind that the aggravation of symptoms cannot be predicted; therefore, symptomatic arachnoid cysts should be treated without undue delay.

Influence of RNFL Thickness on Visual Acuity and Visual Field in Bilateral Temporal Optic Atrophy

PURPOSE: To investigate the influence of retinal nerve fiber layer (RNFL) thickness on visual acuity and visual field in patients with bilateral temporal optic atrophy. METHODS: Patients with characteristic features of gradual visual loss and temporal atrophy of both optic nerves were enrolled in this study. Among the patients, RNFL thickness of each area was measured with optical coherence tomography, and its influence on the best corrected visual acuity, mean deviation and pattern standard deviation calculated from the refractive test and Humphrey visual field test was analyzed. RESULTS: The present study included 13 patients with bilateral temporal optic atrophy (26 eyes) and 13 normal controls (26 eyes). Optical coherence tomography was performed to calculate RNFL thickness in the 52 eyes. Among 26 eyes of patients with bilateral temporal optic atrophy, the Humphrey visual field test was performed to calculate the mean deviation and pattern standard deviation. The mean age in the patient group was 66.0 ± 12.3 years (37-80 years), and 8 (30.8%) patients were male and 18 (69.2%) female. The mean best corrected visual acuity was 30/50 (20/200-20/20). Simple regression analysis showed that a thinner temporal RNFL thickness was correlated with a lower the best corrected visual acuity (p = 0.015). The mean deviation was low when inferotemporal RNFL was thin (p = 0.005). Pattern standard deviation was high when inferotemporal (p = 0.003), inferonasal (p = 0.04) and nasal (p = 0.008) RNFLs were thin. CONCLUSIONS: Inferotemporal RNFL thickness was significantly correlated with best corrected visual acuity, mean deviation and pattern standard deviation of automated visual field test in patients with bilateral temporal optic neuropathy. Optical coherence tomography can be further used to estimate visual acuity and visual field defects in patients with optic atrophy.

Effect of Breviscapine on Visual Function of Patients with Primary Open-angle Glaucoma at Middle and Late Stage after Filtration Surgery / 中国药师

Objective:To study the effect of breviscapine on visual function of the patients with primary open-angle glaucoma after filtration surgery. Methods:Twenty-nine cases (42 eyes) of patients with primary open-angle glaucoma at middle and late stage after filtration surgery were selected and randomly divided into the experimental group and the control group according to the defect degree of visual field. The 15 patients (21 eyes) in the experimengtal group ( TG) were intravenously injected 250ml saline containing 50mg breviscapine, while the 14 patients (21 eyes) in the control group (CG) were intravenously injected 250ml saline containing 1g vita-min C. The treatment course was 2 weeks followed by one-week withdrawal. After three treatment courses, the visual function in the two groups was investigated and compared before and after the treatment. Results:After the treatment, the visual field defect value and the thickness of retinal nerve fiber layer of the patients in TG were both better than those before the treatment (P<0. 01,P<0. 05). The values of visual acuity and visual field defect of the patients in TG were significantly better than those of the patients in CG ( P<0. 05, P<0. 01). Conclusion:After intraocular pressure is controlled, breviscapine injection can reduce the vision damage of patients with primary open-angle glaucoma at middle and late stage after filtration surgery and improve the visual field defect.

Analysis of Visual Field Defect in Patient with Brain Lesion

PURPOSE: In this study we analyzed the results of visual field tests in patients diagnosed with a brain lesion in an ophthalmology clinic. METHODS: The medical records of 55 patients who underwent visual field examinations and diagnosed with brain pathology using magnetic resonance imaging (MRI) from January 1, 2005 to June 30, 2014 were retrospectively investigated. RESULTS: Of the 55 patients (M:F = 30:25), 31 displayed symmetrical hemianopsia, a typical visual field defect associated with brain lesions. Twenty-four patients showed atypical visual field defect (20 showed normal visual field despite the brain lesion, 3 had bilateral narrowing of the peripheral visual field in 2 cerebral infarctions and 1 multiple sclerosis, and 1 had horizontal inferior visual field defect in 1 eye from nasopharyngeal cancer). CONCLUSIONS: Patients having a brain lesion with the optic tract invasion may present with atypical visual field defects. The peripheral visual field constriction and horizontal inferior visual field defect in 1 eye could be the visual field defect in patients with a brain lesion.

A Case of Transient Color Anomaly and Persistent Visual Field Defect after Sildenafil Citrate Overdose

PURPOSE: Sildenafil citrate, is an oral tablet demonstrating efficacy for maintaining an erection in males with erectile dysfunction by inhibiting phosphodiesterase type 5 (PDE5). In the present study, we report 1 case of a transient color anomaly with visual field defect after an overdose of sildenafil citrate. CASE SUMMARY: One patient, a 39-year-old female, with no significant medical history other than previous major depressive disorder, visited an outpatient department due to the visual field defect that began after taking 30 tablets of sildenafil citrate (50 mg) 3 days earlier. A number of ophthalmologic tests were administered including visual acuity test, color vision test, fundus photography and the measurement of retinal structure with optical coherent tomography and her condition was monitored. The best corrected visual acuity was 1.0 in both right and left eyes in her first visit. The color anomaly and a central scotoma of both eyes were detected in the visual field test, while significant signs were not observed after evaluation using optical coherent tomography and fundus photography. After 5 weeks, the visual acuity was not affected, the color anomaly symptom disappeared and the focal visual field defect was present although improved. CONCLUSIONS: Transient color anomaly and persistent central scotoma caused by an overdose ingestion of sildenafil has not been reported in Korea, The related mechanisms may involve the inhibition of PDE5 on ganglion cells and bipolar cells in the retina and interruption of phosphodiesterase type 6 (PDE6) function in both rods and cones.

The Stereoscopic Acuity in Patients with Unilateral or Bilateral Visual Field Defects

PURPOSE: To evaluate the stereoscopic acuity in patients with unilateral or bilateral visual field defects. METHODS: Stereoscopic acuity was measured using the Titmus stereo test for 36 subjects with visual field defects (VFD). VFD was assessed by sum of MD (mean deviation, MDsum) and PSD (pattern standard deviation, PSDsum) of both eyes in Humphrey visual field test and presence of central VFD (within 30degrees isopter) in Goldman visual field test. 25 glaucoma subjects and 11 optic neuritis subjects were included. Patients with strabismus or ocular motility disorders which could affect stereoscopic acuity were excluded. RESULTS: The mean of MDsum was -20.10 +/- 12.31 dB (-45.13~-10.64 dB) and PSDsum was 13.10 +/- 8.76 dB (9.62-25.47 dB). The mean stereoscopic acuity was 710 +/- 922 arc sec (40-3000 arc sec) with Titmus stereo test. The associations between stereoscopic acuity and PSDsum (r = 0.400, p = 0.016), presence of central VFD within 30 degrees (r = 0.428, p = 0.03) were statistically significant. There was positive trend between stereoscopic acuity and duration of VFD, but with no statistical significance. CONCLUSIONS: Decreased stereoscopic acuity was associated with PSDsum and VFD in the central 30 degrees. We should consider this decrease of stereoscopic acuity as well when evaluating visual function of the patients with VFD.