The authors present a retrospective case review of patients with homonymous hemianopia from a 30-year period. Inclusion criteria included completion of perimetry within two years of diagnosis and a MRI brain. Data extracted from the records included demographics, diagnosis details and initial neurological and ophthalmological initial examination. Lesion location on brain MRIs were assigned to one of six areas along the visual pathway, whilst blinded to 24-2 perimetry results. Similarly, visual field defect patterns were categorised into one of 10 patterns, by two authors whilst blinded to other clinical and MRI details. A total of 83 perimetry results met the inclusion criteria. Many cases were excluded due to large unlocalised lesions. It was possible to correlate lesion location with seven of the 10 pre-identified visual field patterns. The authors conclude this study validates the classic concepts of lesion localisation using perimetry. Limitations including a small sample size, exclusion of large lesions are acknowledged by the authors. Another limitation may be the lack of peripheral perimetry in this study. The 24-2 programme was used in all cases, therefore not providing the full extent of the visual field defects. This study adds to the body of evidence that perimetry is a useful tool to support radiologists localise lesions particularly when subtle.
Using perimetry to support lesion location in the retrochiasmal visual pathway
Reviewed by Lauren Hepworth
Visual field defect patterns associated with lesions of retrochiasmal visual pathway.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
View Full Profile
