Abstract
Purpose :
The visual changes in acute stroke are limited in literature although visual projections to the brain occupy more than 40% of the cortical volume and drive most human behaviour. This study identifies such using modern tablet technology.
Methods :
We tested Fifty ischemic stroke patients and Twenty ischemic stroke patients with eye disease (age 32-95) within a week (mean:day3) of admission to Sunshine Hospital at the bed side using an iPad tablet, between July to December, 2018 (Wijesundera et al, 2018). Testing was performed using the Melbourne Rapid Field (MRF-neural) Application for Visual Acuity, Visual Acuity in Noise and Visual Fields. The MRF-neural assays high contrast acuity (Landolt C optotype) and acuity targets immersed in luminance noise. It presents a modified 24-2 pattern for visual field testing. The results were compared to 30 age similar normal controls. All participants provided written consent.
Results :
During the acute phase, most stroke cases have normal high contrast visual acuity (p=0.11) but 46% return reduced acuity-in-noise (p<0.000). 62% cases have visual field defects (MD, p<0.000) with the majority (96%) being hemianopic or quadrantanopic. The stroke patients with eye disease, returned abnormal high contrast visual acuity in 76% of the cases (p<0.000) and reduced acuity-in-noise abnormal visual field dysfunction in 91%(p<0.000).
Conclusions :
Significant deterioration in the visual field and visual acuity-in-noise are present in acute stroke, and the visual function is measurable within a week of a stroke using tablet technology. Near normal high contrast acuity is preserved in the acute phase of a stroke in but the acuity-in-noise gets affected.
This is a 2020 ARVO Annual Meeting abstract.