Third International Visual Field Symposium - Imaging and Perimetry ...

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ACKNOWLEDGEMENT I am extremely grateful to Prof. Yoshimasa Isayama for his various helpful suggestions during the course of this study. REFERENCE Anderson, D.R. Ascending and descending optic atrophy produced experimentally in squirrel monkeys. Am. J. Ophthalmol. 76: 693-711 (1973). Behrendt, T. & Wilson, L.A. Spectral reflectance photography of the retina. Am. J. Ophthalmol. 59: 1079-1088 (1965). Hoyt, W.F., Schlicke, B. & Eckelhoff, R.J. Funduscopic appearance of a nerve-fiber- bundle defect. Br. J. Ophthalmol. 56: 577-583 (1972). Hoyt, W.F., Frisen, L. & Newman, N.M. Funduscopy of nerve fiber layer defects in glaucoma. Invest. Ophthalmol. 12: 814-829 (1973). Isayama, Y. & Tagami, Y. Quantitative Maculometry using a new instrument in cases of optic neuropathies. Docum. Ophthalmol. Proc. Series 14: 237-242 (1977). Lundstrom, M. & Fridn, L. Evolution of descending optic atrophy, a case report. Acta. Ophthalmol. 53: 738- 746 (1975) Lundstrom, M. & Fridn, L. Atrophy of optic nerve fibers in compression of the chiasma, degree and distribution of ophthalmoscopic changes. Acta. Ophthalmol. 54: 623-640 (1976). Tagami, Y. & Isayama, Y. Funduscopic appearance of nerve fiber bundles in optic nerve disorders. Jap. Rev. Clin. Ophthalmol. 70: 238-242 (1976). Author’s address: Department of Ophthalmology School of Medicine Kobe University Kusunoki-cho, 7-chome, Ikuta-ku Kobe, Japan 26
VISUAL FIELD DEFECTS DUE TO TUMORS OF THE SELLAR REGION YOSHIMASA ISAYAMA (Kobe, Japan) ABSTRACT This report is based on a review of pre-operative visual field changes in 135 patients with sellar and parasellar tumors, all of them having operated either at the ophthalmological or the nemosurgical clinics of Kobe University, all in the years from 1968 to 1977. 1) Classification of 66 cases of pituitary adenoma, 31 cases of craniopharyngioma, 24 cases of meningioma and 14 cases of miscellaneous tumors. 2) Division of visual field defects into three groups: a) the symmetric type, b) the asymmetric type and c) the atypical type with detailed discussion. 3) Evaluation of various penmetric measurement methods for chiasmal tumors. 4) Discussion of central field observations including sparing macula. INTRODUCTION It is a wellknown fact that the ocular signs and symptomes of the chiasmal syndrome consist of a bitemporal visual field defect and pallor of the optic disc; such cardinal changes in the visual field occur only at the advanced stage of tumors. With carefully performed perimetry can be found a number of slight variations, such as scotomatous field defects and irregular depres- sions of the peripheral field etc. at an early stage of a chiasmal lesion. Attention to this fact has been drawn by various researchers (Adler, Austin & Grant 1948, Bakey 1950, Chamlin, Davidoff & Feiring 1955, Cushing & Walker 1915, Harms 1954, Henderson 1939, Lyle & Clover 196 1, Imachi, Inoue, Kani & Umeda 1969, Walsh & Hoyt 1969). This report is mainly based on a review of pre-operative visual field changes in 135 patients with sellar and parasellar tumors, all of them having been operated either at the ophthalmological or the neurosurgical clinics of Kobe University and the tumors having been ascertained, all in the years from 1968 to 1977. The first table shows the list of tumors under observation: among them there are 66 cases of pituitary adenoma - of which 53 classified as chromo- phobe adenoma and 13 as eosinophilic adenoma - 31 cases of craniopharyngioma, 24 cases of meningioma of the tuberculum sellae (the sphenoidal ridge and the olfactory groove) and finally 14 cases of miscellaneous tumors. The main procedure of examination of the visual field defects produced by the chiasmal lesion was done kinetically with the Goldmann’s perimeter. 27
Page 1 and 2: Third International Visual Field Sy
Page 3 and 4: Third International visual i: ii~,d
Page 5 and 6: CONTENTS E.L. Greve: Introduction .
Page 7 and 8: Session IV. Methodology Chairman: H
Page 9 and 10: of the R.N.L. may not be accompanie
Page 11 and 12: Docum. Ophthal. Proc. Series, Vol.
Page 13 and 14: conduction disturbances. Their caus
Page 15 and 16: Sofue 1975, Sommer, Miller, Pollack
Page 17 and 18: areas but they can occur also in ot
Page 19 and 20: ut only thinning of the arcuate bun
Page 21 and 22: metric strategies, it affords an ob
Page 25 and 26: Table 1. Atrophic stages of maculop
Page 27 and 28: VS=20/60 Fig. 3. Red-free fundus ph
Page 29 and 30: I 20/20 l- 1.0 1.2- 20/25 ,- 20/30
Page 31: It could be observed, in red-free f
Page 35 and 36: 1. FIRST GROUP: THE SYMMETRIC TYPE
Page 37 and 38: Table 4. Visual field defects due t
Page 39 and 40: chiasm and above either of the opti
Page 41 and 42: and 20/40 for the respective eyes t
Page 43 and 44: advantages of applying other perime
Page 45 and 46: Fig. 7. The pseud-macular sparing:
Page 47 and 48: defect due to central integration o
Page 51 and 52: disturbance of perception is visibl
Page 53 and 54: Supraliminal stimuli still show a b
Page 55 and 56: tion (Dannheim 1977, 1978). These f
Page 57 and 58: Huber, A. Chiasmasyndrome - Klinik.
Page 59 and 60: Table 1. Incidence of age, sex and
Page 61 and 62: Table 3. Time interval between the
Page 63 and 64: Table 5. Initial and final visual a
Page 65 and 66: Table 7. State of the optic disc at
Page 67 and 68: Visual field defects. Table 12 summ
Page 69 and 70: Effect of the time lag between the
Page 71 and 72: Table IS. Effect of systemic cortic
Page 73 and 74: In contrast to Group I, usually no
Page 75 and 76: series. The following case vividly
Page 77 and 78: Docum. Ophthal Proc. Series, Vol. 1
Page 79 and 80: well as cases due to Diabetes. As c
Page 81 and 82: a- b - ht:Mii,H Fig. 4. Typical def
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of both diseases, just as the infer
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of minor ONH therefore include a de
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Fig. 2. Visual field defect due to
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less complete lesions certainly are
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probably congenital hydrocephalus w
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area was involved as well. In 4 fie
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chiasma. Although transient papillo
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REFERENCES Bynke, H. & Heijl, A. Au
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*U. y: R-• 01.. 1Q69. V..T DY.ST
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98 y=’ -’ 40 cl.0 ,,' .4 ,' 3'
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REFERENCES Matsuda, H. & Nakabayash
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Perhaps we can bring this up in a c
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there have been no visual symptoms
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could understand supra-se&r meningi
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I found in pituitary adenoma and in
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Docum. Ophthal. Proc. Series, Vol.
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tided to compare the two eyes to se
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Fig. 4. (Lichter). Nucleus of a def
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Fig. 6. (Lichter). Nucleus of a def
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THE EARLY VISUAL FIELD DEFECT IN GL
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central tests were done with the be
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Fig, 4. Earliest field defect showi
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ences were normally distributed aro
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was found. The first patients of th
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fibre bundle. This group has been f
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On the one hand the w.s.d. may be r
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REFERENCES Armaly, M.F. Selective p
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followed over a one-year period. So
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RESULTS Forty-nine out of 49 open a
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DISCUSSION AND CONCLUSIONS 1. 1. Al
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Table I. JR OD Month I.O.P. mm HG 1
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was almost always abnormal if the s
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perties. II. Dichoptic properties o
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until now had to watch for the appe
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In the following time pressure cont
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matous perimetric changes (Aulhorn
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genital or closed angle glaucoma or
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60 50 40 30 20 10 0 MEDIANS bsx OHn
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those who developed glaucoma with t
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that did not yet show a break-throu
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CASE REPORTS Case 1.: a 52-year-old
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172 Goldmann-field Tiibinger nasal
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174 Friedman-fidd New Front Plate f
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Leblanc, R. Peripheral nasal field
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types of defects described, Goldman
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similar areas of the field. Additio
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Fig. 2. Visual field of the right e
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Table 1. The same type of defects s
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tion tonometer) at time of initial
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treated eyes (5/61 or 8.2%) than in
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was not quite statistically signifi
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early, disappeared entirely. Howeve
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The results of this investigation e
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30’ a) asb 32 10 32 100 320 1000
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OVER-ALL CONCLUSIONS Some degree of
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eye with a modified Goldmann-Weeker
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flow of axoplasm in the optic nerve
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Vanderburg, D. & Drance, S.M. Studi
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naga, Endo & Matsuo 1976). We initi
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up examinations. AU the eyes withou
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41 among 69 (59%), were located in
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oped relative field defects. In the
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utilizing the static method of peri
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CASE PRESENTATIONS For the first tw
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DISCUSSION As a bundle of nerve fib
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REVERSIBILITY OF VISUAL FIELD DEFEC
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glaucoma with use of some agents bu
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lyzer showed paracentral slight spo
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no disappearance. In 9 eyes progres
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closure glaucoma, in early stage id
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(Isayama & Tagami, 1977) in order t
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fiber bundle defects did not corres
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However, after the ocular pressure
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FllE3UENCY of FIWDIN6 EMly 6LAUCOYA
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gression. Each visual field was div
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DISCUSSIONS AND COMMENTS Aulhom dev
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we 10 - 8- 0 eye 10 - 5- J-J o4 10
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REFERENCES Aulhom, E. & Harms, H. E
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Page 256 and 257:
Page 258 and 259:
no major effect of the water drinki
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Case b, right eye, 45" meridian +-+
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REFERENCES Aoyama, T. Pupillographi
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These authors of the second group d
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The behaviour of type 1) must be co
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isolated defect of the Bjerrum area
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choosing the direction of your prof
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How does one explain contraction on
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adequate way if we could understand
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analyse, you can see how well they
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(L. Ron&i and L. Barca. biological
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with a way to teach the clinician t
Page 282 and 283:
Page 284 and 285:
Page 286 and 287:
The relevant quantities are defined
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The average number n of false scoto
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criteria will suffice for the separ
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Let us consider the two arrangement
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esults of an initial low-resolution
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practical applications, for patholo
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examination phase also provides inf
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Section: 1. Characters ‘READY’
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In order not to disturb the subject
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A B Fig. 5. Result with the semi-au
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3 Fig. 2. Left visual field in a pa
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In the remaining 8 fields of 5 case
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Docum. OphthaI. Proc. Series, Vol.
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ROLE OF STANDARDISATION IN AUTOMATE
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REFERENCES Aulhorn, E Ueber die Aut
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Matsuo. Any other comment on Dr. Fa
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need an infinite number; I don’t
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not separate clearly between normal
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SUMMARY OF SESSION III: AUTOMATION
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RESULTS Visual fields were measured
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etinal edema was seen. The visual a
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DISCUSSION In the new fundus contro
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Fig. 8. Occlusion of arterial branc
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ACKNOWLEDGEMENTS The authors would
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NEW FUNOUS PHOTO PERIMITER-OPTICAL
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354 Fig. 4. Heredodegeneration of m
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_No. 9 Diag.NeuritiS optica retrobu
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Fig. 7 shows caecocentral scotoma p
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360 Fig. 1. (See text) Fig. 2. (See
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were obtained from several cases of
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significance of eye-rotation in per
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through an actual change in sensiti
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Docum. Ophthal. Proc Series, Vol 19
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angiography (FFA) and differential
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Fig. 2a. Results of FFA of case 2 (
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Case 4: A woman of 68 years was see
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-.. 378 Fig. 4.5. Results of FFA in
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3. indicating very sensitively the
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added distorting components are pre
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INVERSION Fig. 1. A tangent screen
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Case History VC is a 42-year-old Ca
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a=# 0 OTHERS * REDUCED SENSITIVITY
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gential errors has been made. In es
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that a functional anomaly is prefer
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In the cases of this group, hemorra
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399
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are mainly represented by the PCS g
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oquine retinopathy, 2 eyes of centr
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Table 2. FVFA Profiles of PRD. 406
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REFERENCES Friedmann, AL The assesm
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stimulus used by Verriest and Israe
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In Figure 3, threshold gradients ar
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Matsuo: I would like to proceed to
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SUMMARY OF SESSION IV: METHODOLOGY
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puts in work all the processus inhe
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to the luminous conditions of backg
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MEASURES OF HOW WELL A PROCEDURE DI
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A general idea or model about the c
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enough to understand the test. Fig.
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visual function is normal. Therefor
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ackground field up to 50’ of visu
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clearly isolated with this perimete
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15’ nasal IO 5’ 0’ 5” tempo
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Fig 2, A new attachment (left) and
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and 6000 asb. in rabbit No. 2. Fig.
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Case 2. Cihoretinal occlusion. Male
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detected by kinetic perimetry were
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Fig. 6. The thresholds of two prese
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Docum. Ophthal. PIOC. Series, Vol.
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peripheral parts of the retina, the
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2. Characteristics of Vertex Potent
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Regarding the characteristics of th
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changes could be detected without P
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An isolated nasal PVF defect in the
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Docum. Ophthal. PIOC. Series, Vol.
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determination of the achromatic inc
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field ‘and also other methods, fo
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REPORT OF THE IPS RESEARCH GROUP ON
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white or colour perimetry. Lakowski
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heard. I am not a neophyte in Japan
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T. Aoyama, 265 M.F. Armaly, 177 E.
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