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Characterizing Visual Field Defects with Tangent Screen Perimetry in Organic Versus Non-Organic Pathologies.

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Summary
This summary is machine-generated.

Tangent screen perimetry effectively distinguishes functional visual loss (FVL) from organic visual loss (OVL). Specific patterns and a lower tangent ratio (TR) indicate FVL, aiding diagnosis in visual field constriction cases.

Keywords:
functional visual lossorganic visual losstangent screen perimetry

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Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology
  • Visual field testing

Background:

  • Tangent screen perimetry (TSP) detects functional visual loss (FVL) when visual fields don't expand with distance.
  • Limited research exists on TSP patterns in organic visual loss (OVL), defined by structural/neurologic pathology.
  • This study characterizes TSP patterns in OVL and FVL to assess TSP's diagnostic efficacy for FVL.

Purpose of the Study:

  • To characterize visual field patterns in patients with OVL and FVL using TSP.
  • To evaluate the diagnostic efficacy of TSP in confirming FVL.
  • To analyze the tangent ratio (TR) as a diagnostic marker for FVL.

Main Methods:

  • Retrospective review of 126 eyes from 76 patients with visual field constriction (within 30 degrees) at Seoul National University Bundang Hospital (2009-2019).
  • Comprehensive neuro-ophthalmologic exams and additional tests confirmed OVL or FVL diagnoses.
  • Defined tangent ratio (TR) as average visual field at 2m divided by average visual field at 1m.

Main Results:

  • 'Clover leaf' and 'reversal' patterns were observed in 8.8% and 12.7% of FVL cases, respectively; absent in OVL cases (p=0.002, p<0.001).
  • Mean TR was 0.65 ± 0.15 for FVL versus 0.77 ± 0.16 for OVL (p<0.001).
  • Younger age, specific TSP patterns, and lower TR were significantly associated with FVL.

Conclusions:

  • Tangent screen perimetry is a valuable adjunct for differentiating FVL from OVL.
  • Specific TSP patterns ('clover leaf', 'reversal') and a lower TR are indicative of FVL.
  • TSP aids in diagnosing FVL, especially in cases with visual field constriction.