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OBJECTIVES@#To study the quantitative and qualitative differences of visual evoked potential (VEP) in monocular visual impairment after different parts of visual pathway injury.@*METHODS@#A total of 91 subjects with monocular visual impairment caused by trauma were selected and divided into intraocular refractive media-injury group (eyeball injury group for short), optic nerve injury group, central nervous system injury and intracranial combined injury group according to the injury cause and anatomical segment. Pattern Reversal visual evoked potential (PR-VEP) P100 peak time and amplitude, Flash visual evoked potential (F-VEP) P2 peak time and amplitude were recorded respectively. SPSS 26.0 software was used to analyze the differences of quantitative (peak time and amplitude) and qualitative indexes (spatial frequency sweep-VEP acuity threshold, and abnormal waveform category and frequency) of the four groups.@*RESULTS@#Compared with healthy eyes, the PR-VEP P100 waveforms of the intraocular eyeball injury group and the F-VEP P2 waveforms of the optic nerve group showed significant differences in prolonged peak time and decreased amplitude in injured eyes (P<0.05). The PR-VEP amplitudes of healthy eyes were lower than those of injured eyes at multiple spatial frequencies in central nervous system injury group and intracranial combined injury group (P<0.05).The amplitude of PR-VEP in patients with visual impairment involving central injury was lower than that in patients with eye injury at multiple spatial frequencies. The frequency of VEP P waveforms reaching the threshold of the intraocular injury group and the optic nerve injury group were siginificantly different from the intracranial combined injury group, respectively(P<0.008 3), and the frequency of abnormal reduction of VEP amplitude of threshold were significantly different from the central nervous system injury group, respectively(P<0.008 3).@*CONCLUSIONS@#VEP can distinguish central injury from peripheral injury, eyeball injury from nerve injury in peripheral injury, but cannot distinguish simple intracranial injury from complex injury, which provides basic data and basis for further research on the location of visual impairment injury.
Subject(s)
Humans , Evoked Potentials, Visual , Eye , Optic Nerve , Optic Nerve Injuries , Vision Disorders/etiologyABSTRACT
[Objective] To study the factors relative to the delayed diagnosis of spontaneous dual arteriovenous fistulas (DAVF) and its influence on the prognosis.[Methods] We included 102 continuous patients diagnosed DAVF in the First Affiliated Hospital of Sun Yat-sen University,and analyzed the correlative factors and impact on outcome of diagnostic delay.Outcome was whether symptoms were non-improvement,improvement or restoration at discharge.[Results] Median delay from onset to diagnosis was 3 months (interquartile range,1 to 6).Compared with patients diagnosed carlier(diagnose time≤3 months),patients diagnosed later (diagnose time ＞ 3 months) had a lower frequency of headache (P =0.012),ptosis (P =0.035) and parenchymal lesions (P =0.001),a higher frequency of conjunctival congestion (P =0.004),tinnitus (P =0.021),visual dysfunction (P ＜ 0.001),isolated visual dysfunction (P =0.007) and delayed imaging scan (P ＜ 0.001),a higher frequency of endovascular treatment,and a lower frequency of improvement or restoration at discharge (P =0.033),in which patients with visual dysfunction had a lower frequency of improvement or restoration than those without visual dysfunction (P =0.023).Compared to those with visual dysfunction and other symptoms,patients with isolated visual dysfunction had a higher frequency of onset with paroxysmal blurring or blinding (P ＜ 0.001),two eyes involved (P ＜ 0.001) and more severe visual loss (P =0.057),a higher frequency of draining into transversesigmoid sinus (P ＜ 0.001) instead of cavernous sinus (P ＜ 0.001),and suffered intracranial hypertension all (median intracranial pressure,405 mmH2O;interquartile range,370 ～ 512 mmH2O).However,no statistically significant differences were found in the frequency of improvement or restoration at discharge between two groups (P =0.739).[Conclusion] Diagnostic delay was considerable in this cohort and was associated with outcome,especially in patients with visual dysfunction.
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Unruptured cerebral aneurysms sometimes present with visual symptomsdue to compression of the visual pathways. However, until now, unruptured anterior communicating artery (ACoA) aneurysms presenting visual field defects have been extremely rare. The authors report the case of a 51-year-old woman who presented with left homonymous hemianopsia. Radiological findings demonstrated an ACoA aneurysm filled with thrombus, that was compressing the optic chiasm and post-chiasmal tract. The patient underwent clipping of the aneurysm, which resolved the visual field defect. In cases of visual field defects, an ACoA aneurysm should be included in the differential diagnosis.
Subject(s)
Female , Humans , Middle Aged , Aneurysm , Arteries , Diagnosis, Differential , Hemianopsia , Intracranial Aneurysm , Optic Chiasm , Thrombosis , Visual Fields , Visual PathwaysABSTRACT
AIM:To investigate the value of pattern visual evoked potential (PVEP) and flash electroretinogram (FERG) in early diagnosis and prevention of diabetic retinopathy (DR), analyzing the correlation of early stage DR with PVEP and FERG. METHODS: Sixty patients, 30 males and 30 females, participated in observation group. Their average age was 19. 42 ± 7. 78years. The duration of DM was RESULTS: In observation group, P100 amplitude decreased and P100 latency increased, compared to those of control group ( PCONCLUSION: PVEP are sensitive to optic neuron damage; FERG is desirable to detect the lesion of Müller cells and bipolar cells. P100 amplitude by PVEP, b-wave amplitude by FERG may be the most sensitive parameter for DR at early stage.
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Objective To study the clinical features of visual dysfunction in children with cerebral palsy (CP) and related factors. Methods Between 2006 and 2009, one hundred and sixty-three children (aged 4 to 108months, mean age 29.05 ± 20.51 months) with CP at Qingdao's Rehabilitation Center for Disabled Children were enrolled into this study, including 117 boys and 46 girls. All the children were retrospectively reviewed for perinatal risk factors. Ophthalmologists examined their visual parameters, including refraction, visual acuity, eye position and movement, and fundoscopy. Results Among the 163 children, 61 had visual dysfunctions, an occurrence rate of 37.4%. They included refractive errors in 39 (23.9%) , strabismus in 50 (30.7%) , abnormal eye movement in 26(15.9%) , and abnormal fundoscopic findings in 13 (7.9%). Thirty-seven children's visual acuity was examined,and 19 of them (51.4%) had low visual acuity. Patients who showed periventicular leukomalacia (PVL) or lesions in the occipital lobe on MRI examination had a high incidence of visual dysfunction. Preterm and low birth-weight were risk factors for visual dysfunction in these CP children. Conclusions Visual dysfuntion is a common complication in CP children. Early ophthalmological assessment and intervention are important for CP children.
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@# Visual dysfunction is a common complication in cerebral palsy, including low visual acuity, refractive errors, strabismus, abnormal visual field, absent stereopsis, abnormal fundoscopic fingdings and nystagmus, etc. Low visual acuity is reported in almost three-quarters of patients.The incidence of strabismus is 39%～50% and nystagmus is 9.5%. Periventricular leukomalacia, introventricular hemorrhage and low birth weight are risk factors of visual dysfunctions in cerebral palsy.
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Objetivo: avaliar as amplitudes das respostas eletrorretinográficas multifocais de pacientes com perda visual decorrentes de toxoplasmose ocular. Método: estudo longitudinal prospectivo comparativa no qual foi usado o sistema VERIS Science v6.0.5d para estimulação, registro e extração da resposta para cada hexágono que constitui o estímulo em 3 sujeitos com toxoplasmose ocular (grupo estudo) e 10 sujeitos saudáveis (grupo controle). Os dados dos registros foram exportados para análise no ambiente de programação MATLAB. Neste ambiente de programação foi realizada a análise dos componentes principais sobre as respostas multifocais para aumentar a razão sinal-ruído dos registros. A amplitude do registro dos pacientes foi comparada com os resultados do grupo controle. Foi realizada a avaliação psicofísica do campo visual em todos os indivíduos através da perimetria estática de Humphrey. Resultados: os registros de todos os sujeitos saudáveis exibiram três deflexões como descritos internacionalmente. Nos pacientes com toxoplasmose ocular os resultados da amplitude de resposta apresentaram semelhanças dos obtidos com a perimetria visual. Conclusão: a eletrorretinografia multifocal permite quantificar as perdas de sensibilidade retiniana em pacientes com toxoplasmose ocular de uma forma que pode ser diretamente comparável à avaliação psicofísica do campo visual.
Purpose: to perform a quantitative analysis of the visual losses of three patients suffering from ocular toxoplasmosis by using multifocal electroretinography. Methods: a VERIS Science v6.0.5d hardware and software was used to evoke retinal bioelectric activity, to record this activity, and to extract its first order kernel. Data were exported to MATLAB environment to perform a principal component analysis of the first order kernel. Multifocal eletroretinography obtained from patients were then compared with those obtained from healthy subjects. We performed psychophysical assessment of visual in all subjects through the static Humphrey perimetry Results: recordings from healthy subjects exhibited three components. Ocular toxoplasmosis patients had decreased response amplitude in many areas of the retina and the pattern of visual loss is similar to that found by threshold static automated perimetry. Conclusion: patients with ocular toxoplasmosis showed different degrees of visual impairment that were revealed by using multifocal electrorretinography. The electrophysiological losses matched those revealed by threshold static automated perimetry.
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Posterior cortical atrophy(PCA) is a presenile dementia that presents primarily with signs and symptoms of cortical visual dysfunction, while memory is relatively preserved until the late stage of the disease. We report a patient with PCA, confirmed by brain magnetic resonance imaging (MRI) and F18-fluorodeoxyglucose positron emission tomography(FDG PET). A 58-year-old right-handed woman presented initially with visual dimness and difficulty finding things around her. She had partial Balint's syndrome, partial Gerstmann syndrome, and idiomotor apraxia. She also had a mild memory disturbance, but preserved insight of her disease. Neuropsychological evaluation showed decreased parietal and left temporal functions bilaterally. Brain MRI and F18-FDG PET revealed typical bilateral occipitoparietal atrophy and hypometabolism, which were slightly worse on the right side. Cholinesterase inhibitor administration for 6 months improved the memory impairment slightly, but not the cortical visual dysfunction. This is a typical case of PCA, confirmed by neurologic signs and imaging findings.
Subject(s)
Female , Humans , Middle Aged , Alzheimer Disease , Apraxias , Atrophy , Brain , Cholinesterases , Dementia , Electrons , Gerstmann Syndrome , Glycogen Storage Disease Type VI , Magnetic Resonance Imaging , Memory , Neurologic Manifestations , Passive Cutaneous AnaphylaxisABSTRACT
We measured visual performance in achromatic and chromatic spatial tasks of mercury-exposed subjects and compared the results with norms obtained from healthy individuals of similar age. Data were obtained for a group of 28 mercury-exposed subjects, comprising 20 Amazonian gold miners, 2 inhabitants of Amazonian riverside communities, and 6 laboratory technicians, who asked for medical care. Statistical norms were generated by testing healthy control subjects divided into three age groups. The performance of a substantial proportion of the mercury-exposed subjects was below the norms in all of these tasks. Eleven of 20 subjects (55 percent) performed below the norms in the achromatic contrast sensitivity task. The mercury-exposed subjects also had lower red-green contrast sensitivity deficits at all tested spatial frequencies (9/11 subjects; 81 percent). Three gold miners and 1 riverine (4/19 subjects, 21 percent) performed worse than normal subjects making more mistakes in the color arrangement test. Five of 10 subjects tested (50 percent), comprising 2 gold miners, 2 technicians, and 1 riverine, performed worse than normal in the color discrimination test, having areas of one or more MacAdam ellipse larger than normal subjects and high color discrimination thresholds at least in one color locus. These data indicate that psychophysical assessment can be used to quantify the degree of visual impairment of mercury-exposed subjects. They also suggest that some spatial tests such as the measurement of red-green chromatic contrast are sufficiently sensitive to detect visual dysfunction caused by mercury toxicity.
Subject(s)
Humans , Male , Adolescent , Adult , Middle Aged , Color Perception/drug effects , Color Vision Defects/chemically induced , Contrast Sensitivity/drug effects , Mercury/toxicity , Occupational Diseases/chemically induced , Occupational Exposure/adverse effects , Brazil , Case-Control Studies , Color Vision Defects/diagnosis , Environmental Pollutants , Environmental Exposure/adverse effects , Laboratory Personnel , Mining , Mercury/urine , Occupational Diseases/diagnosis , Spectrophotometry, Atomic , Time FactorsABSTRACT
Objective To investigate the difference of clinical characteristics and treatment outcome between pituitary apoplexy with and without inducing factors. Methods The clinical characteristics and treatment outcome between 12 pituitary apoplexy with inducing factors and 30 pituitary apoplexy without ones. Results Compared with the patients of pituitary apoplexy without inducing factors, the patients of pituitary apoplexy with inducing factors more frequently occurred visual dysfunction(P=0.020) and visual field defection(P=0.046), and the diagnosis of pituitary apoplexy was also delayed in the latter (P=0.015). Conclusion Inducing factors of pituitary apoplexy often aggravated the apoplexy, delayed its diagnosis and treatment due to atypical clinical symptoms, and caused worse restoration of visual function. Headache patients with abrupt visual deterioration should be considered suffering from pituitary apoplexy.