Visual field findings after a ruptured intracranial aneurysm

Area of Science:

• Neurology
• Ophthalmology
• Neurosurgery

Background:

• Visual field defects (VFDs) significantly impair daily activities and rehabilitation post-aneurysmal subarachnoid hemorrhage (aSAH).
• Understanding the prevalence and predictors of VFDs is crucial for patient management and outcomes.

Purpose of the Study:

• To assess VFDs in patients following aSAH.
• To investigate associations between VFDs and demographic factors, aSAH severity, and clinical outcomes.

Main Methods:

• Prospective study of aSAH patients admitted to Helsinki University Central Hospital.
• Visual fields assessed using Octopus 900, Goldmann perimetry, or confrontation testing at multiple time points.
• Uni- and multivariate logistic regression analyzed associations between VFDs and clinical, radiological, and demographic data.

Main Results:

• 19% of survivors at 6 months had VFDs, most commonly homonymous hemianopias/quadrantanopias.
• VFDs were significantly associated with Hunt and Hess (H&H) grade, WFNS grade, Fisher grade, intracerebral hemorrhage (ICH), hydrocephalus, and modified Rankin Scale scores.
• H&H grade and presence of ICH independently predicted VFDs.

Conclusions:

• VFD assessment is recommended for aSAH patients.
• Particular attention should be paid to patients with poor-grade aSAH (H&H grade IV or V) and ICH due to their higher risk of VFDs.