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Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series

BACKGROUND: Accurate diagnosis in patients presenting with lesions at various locations within the visual pathway is challenging. This study investigated functional and structural changes secondary to such lesions to identify patterns useful to guide early and effective management. METHODS: Over 10,...

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Autores principales: Zangerl, Barbara, Whatham, Andrew, Kim, Juno, Choi, Agnes, Assaad, Nagi N, Hennessy, Michael P, Kalloniatis, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434818/
https://www.ncbi.nlm.nih.gov/pubmed/27728957
http://dx.doi.org/10.1111/cxo.12478
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author Zangerl, Barbara
Whatham, Andrew
Kim, Juno
Choi, Agnes
Assaad, Nagi N
Hennessy, Michael P
Kalloniatis, Michael
author_facet Zangerl, Barbara
Whatham, Andrew
Kim, Juno
Choi, Agnes
Assaad, Nagi N
Hennessy, Michael P
Kalloniatis, Michael
author_sort Zangerl, Barbara
collection PubMed
description BACKGROUND: Accurate diagnosis in patients presenting with lesions at various locations within the visual pathway is challenging. This study investigated functional and structural changes secondary to such lesions to identify patterns useful to guide early and effective management. METHODS: Over 10,000 records from patients referred for optic nerve head assessment were reviewed and 31 patients with a final diagnosis of likely neuropathic lesions posterior to the eye were included in the current study. Fundus photographs, optic coherence tomography images and visual field tests were evaluated for changes with respect to retinal nerve fibre layer topography and prediction of structure‐function paradigms. Emerging clinical patterns were examined for their consistency with the likely anatomical origin of the underlying insult in the presence of varying diagnoses. RESULTS: Data from patients with lesions along the visual system allowed identification of retinal nerve fibre layer asymmetry correlated with visual field defects and ganglion cell analysis. Bilateral discordance in retinal nerve fibre loss easily discernible from an altered pattern of the temporal‐superior‐nasal‐inferior‐temporal curve was characteristic for post‐chiasmal lesions. These sometimes‐subtle changes supported diagnosis in cases with multiple aetiologies or with ambiguous visual field analysis and/or ganglion cell loss. CONCLUSION: Intricate knowledge of the retinal architecture and projections allows coherent predictions of functional and structural deficits following various lesions affecting the visual pathway. The integration of adjunct imaging and retinal nerve fibre layer thinning will assist clinicians to guide clinical investigations toward a likely diagnosis in the light of significant individual variations. The case series presented in this study aids in differential diagnosis of retrograde optic neuropathies by using retinal nerve fibre layer asymmetric patterns as an important clinical marker.
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spelling pubmed-54348182017-06-01 Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series Zangerl, Barbara Whatham, Andrew Kim, Juno Choi, Agnes Assaad, Nagi N Hennessy, Michael P Kalloniatis, Michael Clin Exp Optom Research Papers BACKGROUND: Accurate diagnosis in patients presenting with lesions at various locations within the visual pathway is challenging. This study investigated functional and structural changes secondary to such lesions to identify patterns useful to guide early and effective management. METHODS: Over 10,000 records from patients referred for optic nerve head assessment were reviewed and 31 patients with a final diagnosis of likely neuropathic lesions posterior to the eye were included in the current study. Fundus photographs, optic coherence tomography images and visual field tests were evaluated for changes with respect to retinal nerve fibre layer topography and prediction of structure‐function paradigms. Emerging clinical patterns were examined for their consistency with the likely anatomical origin of the underlying insult in the presence of varying diagnoses. RESULTS: Data from patients with lesions along the visual system allowed identification of retinal nerve fibre layer asymmetry correlated with visual field defects and ganglion cell analysis. Bilateral discordance in retinal nerve fibre loss easily discernible from an altered pattern of the temporal‐superior‐nasal‐inferior‐temporal curve was characteristic for post‐chiasmal lesions. These sometimes‐subtle changes supported diagnosis in cases with multiple aetiologies or with ambiguous visual field analysis and/or ganglion cell loss. CONCLUSION: Intricate knowledge of the retinal architecture and projections allows coherent predictions of functional and structural deficits following various lesions affecting the visual pathway. The integration of adjunct imaging and retinal nerve fibre layer thinning will assist clinicians to guide clinical investigations toward a likely diagnosis in the light of significant individual variations. The case series presented in this study aids in differential diagnosis of retrograde optic neuropathies by using retinal nerve fibre layer asymmetric patterns as an important clinical marker. Wiley Publishing Asia Pty Ltd 2016-10-11 2017-05 /pmc/articles/PMC5434818/ /pubmed/27728957 http://dx.doi.org/10.1111/cxo.12478 Text en © 2016 The Authors. Clinical and Experimental Optometry published by John Wiley & Sons Australia, Ltd on behalf of Optometry Australia. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Papers
Zangerl, Barbara
Whatham, Andrew
Kim, Juno
Choi, Agnes
Assaad, Nagi N
Hennessy, Michael P
Kalloniatis, Michael
Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series
title Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series
title_full Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series
title_fullStr Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series
title_full_unstemmed Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series
title_short Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series
title_sort reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series
topic Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434818/
https://www.ncbi.nlm.nih.gov/pubmed/27728957
http://dx.doi.org/10.1111/cxo.12478
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