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Chamini Wijesundera, Algis J Vingrys, Sheila Gillard Crewther, Tissa Wijeratne; Identifying Visual Deficits In Hospitalized Acute Ischemic Stroke Patients Using Tablet Technology.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5042.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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).
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.
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