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Eliza Maria C. Lacerda, Aline C. Carvalho, Lindsay N. Holoman, Mellina M. Jacob, Michel G. Maciel, Givago S. Souza, Alexandre Antônio M. Rosa, Rita Catarina M. Sousa, Malinda E. Fitzgerald, Luiz Carlos L. Silveira; Visual Evaluation Of Immune Competent Subjects Diagnosed With Neurocryptococcosis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4901.
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© ARVO (1962-2015); The Authors (2016-present)
To perform a comprehensive evaluation of the visual system in immune competent subjects diagnosed with neurocryptococcosis.
Seven patients (11-51 years old; 25.3±13.9 years old; 3 males and 4 females) in treatment for neurocryptococcosis were studied. It was performed biomicroscopy (12 eyes), fundoscopy (12 eyes), ocular motility exam (10 eyes), Farnsworth Munsell 100 hue test (7 eyes), color discrimination MacAdam elipses test (7 eyes), spatial contrast sensitivity test (7 eyes), static perimetry (7 eyes), visual acuity (14 eyes), and electrophysiology evaluation comprising ffERG (rod stimulation, mixed cone and rod stimulation, oscillatory potentials recording, light-adapted cone stimulation, 30 Hz flicker stimulation) (12 eyes), 103 hexagons mfERG (10 eyes), pERG, (14 eyes), and pVECP (14 eyes). Patients’ data were compared with a control group age- and gender-matched. Tolerance intervals was used for psychophysics and confidence interval was used for visual electrophysiology as recommended by ISCEV (α = 0.05).
Biomicroscopy and fundoscopy. Seven eyes had optic nerve atrophy or papilloedema and seven eyes had normal results. Ocular motility. Normal at all tested eyes. All the patients had some altered parameter in the psychophyscs or electrophysiology. Among the patients with altered fundoscopy 100% had worst visual acuity than normal, 71.4% could not perform psychophysical exams, 85.7% had altered pERG and pVECP, 66.7% had altered central recordings of mfERG, 60% had altered oscillatory potentials, 40% had depressed mix ffERG, cone ffERG, and 30 Hz flicker ffERG, 33.3% had decreased peripheral recordings of mfERG, 20% had altered rod ffERG. Among the patients with normal fundoscopy 57.1% had absent pERG and pVECP, 42.85% had worst visual acuity than normal, 28.5% could not perform psychophysical exams, 25% had depressed central recordings of mfERG, 42% had depressed oscillatory potentials, 42.8% had depressed mix ffERG and cone ffERG, 50% had decreased peripheral recordings of mfERG, 14.2% had altered rod ffERG, none of them had absent or altered 30 Hz flicker ffERG.
Neurocryptococcosis impaired the visual function mainly when the disease is associated to optic nerve changes. Central vision was more depressed. Visual acuity, pERG and pVECP, and mfERG central ring. 30 Hz flicker ffERG was also important test to distinguish both groups.
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