Abstract
Purpose: :
To determine retrospectively the frequency of occurrence of visual field defects in a sample of visually-symptomatic, ambulatory outpatients who have acquired brain injury (ABI), either mild traumatic brain injury (TBI) or cerebrovascular accident (CVA).
Methods: :
The medical records of 220 individuals treated in the Raymond J. Greenwald Rehabilitation Center (RJGRC) either with mild TBI (n=160) or CVA (n=60) were reviewed retrospectively using a computer-based query spanning the years 2000-2003. Records were reviewed to determine the frequency of specific visual field defects: scattered, restricted, homonymous, non-homonymous, lateralized, and altitudinal.
Results: :
In the total ABI sample of 220, 102 (46.4%) individuals were diagnosed with one of the targeted visual field defects, with 62/160 (38.8%) for TBI and 40/60 (66.7%) for CVA, respectively. For TBI, the frequency of occurrence of visual field defects was: scattered (36/62=58.1%), restricted (10/62=16.1%), lateralized (16/62=25.8%), homonymous (14/62=22.6%), non-homonymous (2/62=3.2%), and altitudinal (0/62=0%). For CVA, the frequency of occurrence of visual field defects was: scattered (8/40=20%), restricted (5/40=12.5%), lateralized (27/40=67.5%), homonymous (19/40=47.5%), non-homonymous (8/40=20%), and altitudinal (1/40=2.5%, which was also homonymous).
Conclusions: :
Identification and comparison of the frequency of occurrence of visual field defects in the TBI and CVA samples with earlier studies that have reported on just one of these groupings revealed similar frequencies for TBI and slightly lower frequencies for CVA. Visual field integrity can be assessed in peri-personal and/or extra-personal space with either kinetic or static targets. Since RJGRC used static targets for testing in extra-personal space only, this may be one reason why there was no evidence of visual inattention for either subgroup and a lower percentage of visual field defects in the CVA group. The increased frequency of occurrence (46.4%) of visual field defects in this study's ABI sample will adversely quality of life, such as reading, ambulation, and driving.
Keywords: visual fields • visual impairment: neuro-ophthalmological disease • clinical (human) or epidemiologic studies: prevalence/incidence