ABSTRACT
PURPOSE: To assess the pattern and the local spatial frequency distribution of visual field defects (VFDs) in eyes with clinically diagnosed optic neuritis (ON) and their currently unaffected fellow eyes, using threshold-related, slightly supraliminal perimetry, ensuring high spatial resolution. METHODS: Records obtained with the Tübingen Automatic perimeter (TAP, Oculus Inc., Dudenhofen, Germany) and the Octopus 101 perimeter (Haag-Streit Inc, Koeniz, Switzerland), using a standardized grid of 191 static targets within the central 30 degrees visual field, were analysed retrospectively. VFDs were assigned to 15 classes. RESULTS: Visual fields (VF) from 99 patients (26 male and 73 female subjects, aged from 18 to 51 years) with clinically diagnosed, acute ON (52 right eyes, 48 left eyes affected, one bilateral involvement) were evaluated. Central scotomas were the most common finding in associated eyes, covering 41% of all VFDs in affected eyes. Nerve fibre bundle defects were found in 29% and paracentral scotomas in 14% of all VFDs. Fellow eyes were perimetrically normal in 65% of the clinically monocular ONs. Nerve fibre bundle defects were found in 21% and diffuse scotomas in 9% of the fellow eyes. CONCLUSIONS: Central scotomas and retinal nerve fibre bundle defects are the most common VFDs in acute ON. Small central and paracentral scotomas that most probably would have been missed by automated thresholding perimetry with its relatively coarse grid could be detected by threshold-related, slightly supraliminal strategy. Of the fellow eyes in clinically apparent monocular optic neuritis, 35% present with visual field defects.
Subject(s)
Optic Neuritis/physiopathology , Scotoma/physiopathology , Visual Fields , Acute Disease , Adult , Female , Humans , Male , Middle Aged , Retrospective Studies , Sensory Thresholds , Visual Field TestsABSTRACT
BACKGROUND: Prechiasmal lesions of the visual pathway are produced by visual field defects that either affect only one eye or, if both eyes are affected, they are clearly different. Typically, the defects respect the vertical meridian. This report of a case shows that the classical nerve fibre bundle defect must be taken into consideration for differential diagnosis. CASE REPORT: In a 67-year-old patient, a meningeoma of the sphenoid was diagnosed that had spread into the optic canal. Examination of the visual field showed an inferior altitudinal nerve fibre bundle defect. CONCLUSIONS: Apparently the retinal pattern of nerve fibres remains intact even when approaching the optic chiasm. Nerve fibre bundle defects are therefore sometimes found in prechiasmal lesions and should be considered for differential diagnosis (e. g., in the case of a suspected low tension glaucoma).
Subject(s)
Meningeal Neoplasms/diagnosis , Meningioma/secondary , Nerve Fibers/physiology , Optic Chiasm/physiopathology , Optic Nerve Neoplasms/secondary , Paranasal Sinus Neoplasms/diagnosis , Sphenoid Sinus , Visual Fields/physiology , Aged , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Meningeal Neoplasms/physiopathology , Meningioma/diagnosis , Meningioma/physiopathology , Neoplasm Invasiveness , Optic Nerve/physiopathology , Optic Nerve Neoplasms/diagnosis , Optic Nerve Neoplasms/physiopathology , Paranasal Sinus Neoplasms/physiopathologyABSTRACT
PURPOSE: To evaluate the comparability between the well-established Sheridan-Gardiner test (SGT) and a new type of visual acuity test, called the Räder test (RT = broken wheel test) in pre-school children, and to compare test durations of these infant visual acuity tests. SUBJECTS AND METHODS: The RT consists of 16 cards with visus values of 0.16, 0.2, 0.25, 0.3, 0.5, 0.6, 0.8 and 1.0. One pair of cards depicting a car is used for testing. On one of the cards the car has intact wheels, on the other the wheels are incomplete, symbolized by a Landolt ring. The child must indicate, at a viewing distance of 3 meters, which of the wheels is incomplete. The SGT consists of seven visus plates: 5/60, 5/36, 5/24, 5/18, 5/12, 5/9 and 5/6. Each level is tested with one letter and can be repeated by the presentation of a further letter (A, H, O, T, U, V, X). The examination distance is 5 meters. The child must indicate, with reference to a card depicting all seven symbols, which letter the examiner is showing. The SGT and RT were performed in a randomized cross-over sequence in 30 children (20male, 10 female) of pre-school age (from 2 years up to and including the age of 5 years, mean 3.4 years +/- 0.77 SD, median 3.0 years). In all cases, the right eye was examined first. Examination duration was assessed for each acuity test, and for each eye separately with a stopwatch. The instruction time was not considered. The possible visual acuity values of both bests were replaced by a unified scale of visual acuity levels (ranging from 1 to 10). A difference of at least two levels was considered as relevant. The results were compared by means of the sign test at a significance level of 0.05. RESULTS: In particular, for higher visual acuity levels there were considerable differences, with SGT generally showing better results than RT: in 11 of 29 children, in both eyes RT values turned out to be at least 2 lines better than those obtained with SGT. The contrary situation, i. e., favoring SGT by more than 2 lines compared to RT, never occurred. According to the sign test, these differences were significant (p < 0.001). SGT revealed also clearly better visual acuity levels in those 22 children out of the 30, who exhibited differences by 2 lines or more in at least one eye (p < 0.001). The examination procedure with RT revealed problems in making the required directional decisions, especially between 2 and 4 years of age. This might interfere with the test interpretation and lead to distortion of the RT results. Total examination duration did not differ considerably between SGT (1.6 to 5.8 minutes, median 3.0 minutes) and RT (1.6 to 9.4 minutes, median 4.6 minutes), respectively. CONCLUSIONS: The Sheridan-Gardiner test generally shows better results than the new Räder (RT = broken wheel) test in pre-school children. Problems in making the required directional decisions may interfere with RT in this age group.
Subject(s)
Vision Screening/methods , Vision Tests/methods , Visual Acuity , Bias , Child, Preschool , Cross-Over Studies , Discrimination Learning , Female , Humans , Male , Pattern Recognition, Visual , Reproducibility of Results , Vision Tests/statistics & numerical dataABSTRACT
HMSN is a hereditary symmetric ascending neuropathy of the peripheral nerves. Several cases of HMSN with motility disorders of both eyes have been reported in the literature. We describe a patient with HMSN type 1 and an incomplete peripheral 3rd nerve palsy of the right eye. To the best of our knowledge, this is the first report of developed unilateral oculomotor disorder in a patient with HMSN.
Subject(s)
Hereditary Sensory and Motor Neuropathy/complications , Oculomotor Nerve Diseases/etiology , Adult , Fixation, Ocular , Fluorescein Angiography , Fundus Oculi , Humans , Male , Oculomotor Nerve Diseases/diagnosis , Visual AcuityABSTRACT
Pea plants grown under different conditions of cultivation, and eight different plant species with variegated leaves were used to study the intracellular localization of shikimate oxidoreductase (EC 1.1.1.25), the marker enzyme of the pre-chorismate pathway. The two series of experiments indicated an intra-and an extraplastidic compartimentalization of the enzyme, and both enzyme activities are regulated differentially. While the extraplastidic activity is permanently demonstrable, the intraplastidic activity is subject to the plants' developmental state and also depends on both illumination and fertilization.
