rss
J Neurol Neurosurg Psychiatry 82:695-702 doi:10.1136/jnnp.2010.214387
  • Research paper

Recovery of visual-field defects after occipital lobe infarction: a perimetric study

  1. Timur Köse3
  1. 1Atatürk Research and Training Hospital, Clinic of Neurology, İzmir, Turkey
  2. 2Ege University, Medical School, Department of Neurology, İzmir, Turkey
  3. 3Ege University, Medical School, Department of Biostatistics and Medical Informatics, İzmir, Turkey
  1. Correspondence to Professor Dr Neşe Çelebisoy, Ege University Medical School, Department of Neurology, Bornova, İzmir, 35100, Turkey; nese.celebisoy{at}ege.edu.tr
  • Received 9 April 2010
  • Revised 23 July 2010
  • Accepted 29 July 2010
  • Published Online First 9 October 2010

Abstract

Objective To assess the temporal course of homonymous visual-field defects due to occipital lobe infarction, by using automated perimetry.

Methods 32 patients with ischaemic infarction of the occipital lobe were studied prospectively, using a Humphrey Visual Field Analyser II. The visual field of each eye was divided into central, paracentral and peripheral zones. The mean visual sensitivity of each zone was calculated and used for the statistical analysis. The results of the initial examination, performed within 2 weeks of stroke, were compared with the results of the sixth-month control. The lesions were assigned to the localisations, optic radiation, striate cortex, occipital pole and occipital convexity, by MRI.

Results A statistically significant improvement was noted, especially for the lower quadrants. Lesions of the occipital pole and convexity were not significantly associated with visual-field recovery. However, involvement of the striate cortex and extensive lesions involving all the areas studied was significantly associated with poor prognosis.

Conclusions Homonymous visual-field defects in our patients improved within 6 months. Restoration of the lower quadrants and especially the peripheral zones was noted. Incomplete damage to the striate cortex, which has a varying pattern of vascular supply, could explain this finding. Magnification factor theory, which is the increment of the receptive-field size of striate cortex cells with visual-field eccentricity, may explain the more significant improvement in the peripheral zones.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by The Ethics Committee of Ege University Medical School.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Podcasts
Visit the full archive of podcasts for JNNP here >>

Free sample
This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of JNNP.
View free sample issue >>

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Navigate This Article