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Visual signs and symptoms in patients with the visual variant of Alzheimer disease

BACKGROUND: Prominent visual symptoms can present in the visual variant of Alzheimer’s disease (VVAD). Ophthalmologists have a significant role to play in the early diagnosis of VVAD. METHODS: We retrospectively reviewed the files of ten consecutive patients diagnosed with VVAD. All patients had a f...

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Autores principales: Kaeser, Pierre-François, Ghika, Joseph, Borruat, François-Xavier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485862/
https://www.ncbi.nlm.nih.gov/pubmed/26122482
http://dx.doi.org/10.1186/s12886-015-0060-9
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author Kaeser, Pierre-François
Ghika, Joseph
Borruat, François-Xavier
author_facet Kaeser, Pierre-François
Ghika, Joseph
Borruat, François-Xavier
author_sort Kaeser, Pierre-François
collection PubMed
description BACKGROUND: Prominent visual symptoms can present in the visual variant of Alzheimer’s disease (VVAD). Ophthalmologists have a significant role to play in the early diagnosis of VVAD. METHODS: We retrospectively reviewed the files of ten consecutive patients diagnosed with VVAD. All patients had a full neuro-ophthalmologic examination, a formal neurological and neuro-psychological testing, and cerebral MRI to confirm diagnosis. In addition, functional neuroimaging was obtained in seven patients. RESULTS: The common primary symptom at presentation with all patients was difficulty with near vision (reading difficulty n = 8, “visual blur” in near vision n = 2), and difficulty writing (n = 3). Following assessment, impaired reading and writing skills were evident in 9/10 and 8/10 patients respectively. Median distance visual acuity was 20/25 and at near the median visual acuity was J6. Partial homonymous visual field defect was detected in 80 % (8/10) of the patients. Color vision was impaired in all patients when tested with Ishihara pseudoisochromatic plates, but simple color naming was normal in 8/9 tested patients. Simultanagnosia was present in 8/10 patients. Vision dysfunction corresponded with cerebral MRI findings where parieto-occipital cortical atrophy was observed in all patients. PET scan (5 patients) or SPECT (2 patients) revealed parieto-occipital dysfunction (hypometabolism or hypoperfusion) in all 7 tested patients CONCLUSIONS: Visual difficulties are prominent in VVAD. Dyslexia, incomplete homonymous hemianopia, preserved color identification with abnormal color vision on Ishihara, and simultanagnosia were all symptoms observed frequently in this patient series. Ophthalmologists should be aware of the possibility of neurodegenerative disorders such as VVAD in patients with unexplained visual complaints, in particular reading difficulties.
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spelling pubmed-44858622015-07-01 Visual signs and symptoms in patients with the visual variant of Alzheimer disease Kaeser, Pierre-François Ghika, Joseph Borruat, François-Xavier BMC Ophthalmol Research Article BACKGROUND: Prominent visual symptoms can present in the visual variant of Alzheimer’s disease (VVAD). Ophthalmologists have a significant role to play in the early diagnosis of VVAD. METHODS: We retrospectively reviewed the files of ten consecutive patients diagnosed with VVAD. All patients had a full neuro-ophthalmologic examination, a formal neurological and neuro-psychological testing, and cerebral MRI to confirm diagnosis. In addition, functional neuroimaging was obtained in seven patients. RESULTS: The common primary symptom at presentation with all patients was difficulty with near vision (reading difficulty n = 8, “visual blur” in near vision n = 2), and difficulty writing (n = 3). Following assessment, impaired reading and writing skills were evident in 9/10 and 8/10 patients respectively. Median distance visual acuity was 20/25 and at near the median visual acuity was J6. Partial homonymous visual field defect was detected in 80 % (8/10) of the patients. Color vision was impaired in all patients when tested with Ishihara pseudoisochromatic plates, but simple color naming was normal in 8/9 tested patients. Simultanagnosia was present in 8/10 patients. Vision dysfunction corresponded with cerebral MRI findings where parieto-occipital cortical atrophy was observed in all patients. PET scan (5 patients) or SPECT (2 patients) revealed parieto-occipital dysfunction (hypometabolism or hypoperfusion) in all 7 tested patients CONCLUSIONS: Visual difficulties are prominent in VVAD. Dyslexia, incomplete homonymous hemianopia, preserved color identification with abnormal color vision on Ishihara, and simultanagnosia were all symptoms observed frequently in this patient series. Ophthalmologists should be aware of the possibility of neurodegenerative disorders such as VVAD in patients with unexplained visual complaints, in particular reading difficulties. BioMed Central 2015-06-30 /pmc/articles/PMC4485862/ /pubmed/26122482 http://dx.doi.org/10.1186/s12886-015-0060-9 Text en © Kaeser et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kaeser, Pierre-François
Ghika, Joseph
Borruat, François-Xavier
Visual signs and symptoms in patients with the visual variant of Alzheimer disease
title Visual signs and symptoms in patients with the visual variant of Alzheimer disease
title_full Visual signs and symptoms in patients with the visual variant of Alzheimer disease
title_fullStr Visual signs and symptoms in patients with the visual variant of Alzheimer disease
title_full_unstemmed Visual signs and symptoms in patients with the visual variant of Alzheimer disease
title_short Visual signs and symptoms in patients with the visual variant of Alzheimer disease
title_sort visual signs and symptoms in patients with the visual variant of alzheimer disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485862/
https://www.ncbi.nlm.nih.gov/pubmed/26122482
http://dx.doi.org/10.1186/s12886-015-0060-9
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