June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
The Jigsaw Effect: Clinical Evidence for CNS Control of Visual Field Loss in Chronic Glaucoma
Author Affiliations & Notes
  • Willliam Sponsel
    Biomedical Engineering, University of Texas - San Antonio, San Antonio, TX
    Madison Square Bldg Ste 306, WESMDPA, San Antonio, TX
  • Nancy Satsangi
    School of Medicine, University of Texas Health Science Center - San Antonio, San Antonio, TX
  • Matthew Reilly
    Biomedical Engineering, University of Texas - San Antonio, San Antonio, TX
  • Sylvia Groth
    School of Medicine, University of Minnesota, Minneapolis, MN
  • Stuart McKinnon
    Ophthalmology and Neurobiology, Duke University, Durham, NC
  • Footnotes
    Commercial Relationships Willliam Sponsel, New World Medical (P); Nancy Satsangi, None; Matthew Reilly, None; Sylvia Groth, None; Stuart McKinnon, Merz (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4939. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Willliam Sponsel, Nancy Satsangi, Matthew Reilly, Sylvia Groth, Stuart McKinnon, Australian Research Council Centre of Excellence in Vision Science (ACEVS); The Jigsaw Effect: Clinical Evidence for CNS Control of Visual Field Loss in Chronic Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4939.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

To statistically assess the tendency for the conservation of the binocular visual field in patients with moderate to severe glaucomatous field loss in both eyes. The goal of this work was to determine whether chronic bilateral visual field degeneration can be explained on a bilaterally independent ocular pathologic basis, or if the mathematical evidence indicates that the CNS must help direct the process in an integrated bilateral manner.

 
Methods
 

Case control study. Subjects: 47 patients with stabilized chronic progressive glaucoma undergoing Humphrey Visual Field 30-2 testing were evaluated. One single-session paired set of left (OS) and right (OD) eye visual fields was assessed for each individual. Each OS visual field locus was paired with either (a) its directly comitant OD locus, or (b) a random non-comitant OD locus of equal eccentricity from fixation. Mean threshold values were calculated for the 76 loci of each eye of all 47 subjects. The mean value for the higher of each of the paired individual comitant locus values (HCD) from both eyes, using combinations (b) and (c), were similarly calculated for all subjects, using all 76 points OU, running 10,000 iterations for (b), and compared by paired t-test.

 
Results
 

Global mean thresholds were 14.73 OS and 15.80 dB OD; mean 15.27 OU, ~5 dB lower than the better of the paired loci (p<0.000000001). Mean threshold for direct HCD pairings (a) was 20.55, versus 20.10 (range 19.9-20.2) for (b) (p=0.0002). Mirrored field pairings confirmed that anatomic symmetry factors could not account for the observed differences.

 
Conclusions
 

A very strong tendency for optimizing the binocular visual field, in a manner that defies simple anatomic symmetry considerations, was observed. Direct inspection of the paired visual fields of these patients provides insights into this phenomenon, displaying the interlocking, mutually asymmetric jigsaw-like character of many bilateral scotomata. It is known that focal axonal injury in one eye may be accompanied by increased activity in the contralateral retinal glia and geniculate layers receiving comitant visual information from the fellow non-injured eye (see Bodeutsch et al, J Neurobiol 1999, Penagis et al, Eur J Neurosci 2005, Dai et al, Exp Eye Res 2009). Focal bilateral compensation of this kind may be involved in the conservation of the binocular visual field in patients with chronic progressive glaucoma.

     
Keywords: 758 visual fields • 426 apoptosis/cell death • 531 ganglion cells  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×