Third International Visual Field Symposium Tokyo, May 3–6, 1978

Volume 19 of the series Documenta Ophthalmologica Proceedings Series pp 53-71

Visual Field Defects in Anterior Ischemic Optic Neuropathy

  • S. S. HayrehAffiliated withDepartment of Ophthalmology, University of Iowa
  • , P. PodhajskyAffiliated withDepartment of Ophthalmology, University of Iowa

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In 120 patients (168 eyes) with anterior ischemic optic neuropathy (AION), the pattern of visual field defects, and their relationship to the optic disc changes and visual acuity, were evaluated, both at the start of the disease and after a follow-up period; the various factors which influence the progress of visual field defects were also investigated. Visual field defects were seen much more frequently than defects in the visual acuity in AION. The field defects were present in 100% and 97% of the eyes with AION associated with temporal arteritis (Group I) and without temporal arteritis (Group II) respectively. The pattern of field defects, although complex and diverse, could be classified as optic-disc-related. In Group II, the commonest defects were inferior nasal segmental defect, inferior altitudinal hemianopic defect and central scotoma. In Group I, there was usually massive visual loss so that either no fields were obtained or only a small island field was seen, and in the rest the pattern was otherwise similar to that seen in Group II. In Group II, a marked potential for visual recovery was seen after systemic corticosteroid therapy, as compared to untreated cases (p<0.0005), especially when they were treated soon after the onset of AION while the optic disc still showed a fair amount of edema.