Perimetry, visual evoked potentials and visual evoked spectrum array in homonymous hemianopsia

Area of Science:

• Ophthalmology
• Neuroscience
• Visual Electrophysiology

Background:

• Homonymous hemianopsia is a visual field defect affecting the same side of the visual field in both eyes.
• Accurate diagnosis and monitoring are crucial for managing this condition.
• Various methods exist for visual field assessment, each with unique strengths and limitations.

Purpose of the Study:

• To compare the diagnostic value of confrontation field examination, Goldmann perimetry, visual evoked potentials (VEPs) to pattern hemi-field stimulation, and visual evoked spectrum array (VESA) in patients with homonymous hemianopsia.
• To determine the most effective methods for detecting and characterizing visual field defects in this patient group.

Main Methods:

• Confrontation field examination was performed on 50 patients.
• Goldmann perimetry was attempted in 60% of patients.
• Visual evoked potentials (VEPs) to pattern hemi-field stimulation were tested in 77% of patients.
• Visual evoked spectrum array (VESA) to flash stimulation was tested in 95% of patients.

Main Results:

• Confrontation field examination detected defects in 96% of patients.
• Goldmann perimetry quantitatively defined defect margins but was feasible in only 60%.
• VEPs showed abnormalities in 79% of tested patients and were absent in macular splitting cases.
• VESA revealed abnormalities in 67% of tested patients.

Conclusions:

• Confrontation field examination is a highly sensitive initial screening tool for homonymous hemianopsia.
• VEPs are valuable for detecting abnormalities, especially in cases with macular involvement.
• Goldmann perimetry provides quantitative data but has lower feasibility.
• A combination of methods may offer the most comprehensive assessment.