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M Baur, E Rohlfs, G Magnusson, R Burth, R Vonthein, U Schiefer; Homonymous Visual Field Defects - Influence of Underlying Pathogenesis and the Location of the Lesion on Spontaneous Recovery . Invest. Ophthalmol. Vis. Sci. 2002;43(13):231.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To describe the natural course of homonymous visual field defects (H-VFDs) over time and to determine the influence of underlying pathogenesis and location of the lesion on spontaneous recovery. Methods:We analysed visual field data - obtained with threshold oriented slightly supraliminal static grid perimetry (Tuebingen Automated Perimeter [TAP] 30°, 191 test locations) - of 66 patients (36 men and 30 women, age 14 - 80 years, pathogenesis: 38 vascular lesions, 8 tumors, 5 inflammation, 15 others) with H-VFDs. The data were taken from the perimetry database of the department (January 1997 - November 2000). Statistical evaluation was performed with JMP 4.0.2 (SAS Inst. Inc. Cary NC, 2000). We estimated the odds of a test point to be seen versus an absolute defect with a logistic regression model. Results:The mean trend regarding the development of all patients shows an improvement ( Chi-Square [X2]=113.27, p<0.0001). In the 38 patients with H-VFDs caused by vascular lesions the chance decreased from 6.54:1 at baseline (initial) over 6.46:1 after 3 months to 6.21:1 after one year, a significant deviation from the mean trend ([X2]=190, p<0.0001). Looking at the location of the lesion, the chance rose (5.8:1 at baseline, 6.06:1 after 3 months, 6.9:1 after one year; comparison with mean Odds Ratio(OR): [X2]=19.98; p<0.001) in the 38 patients with H-VFDs as a result of a lesion in the occipital cortex. The increase was slightly more distinct in the 19 patients suffering from H-VFDs caused by lesions of the optic radiation (8.2:1 at baseline (initial), 8.6:1 after 3 months, 10.0:1 after one year; comparison with mean OR: [X2]=13.85; p<0.001). Sample size of other patient groups (e.g. pathogenesis: inflammation; or location: optic tract) was too small to obtain reliable results. Conclusion:Patients whose H-VFDs result from a vascular lesion show a prognosis which is worse than the average.
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