Recovery of visual functions
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Autoři referují o výsledcích retrospektivní studie 25 pacientů s první atakou neuritidy optiku sledované na Oční klinice LF UK a FN v Hradci Králové. V naší studii jsme se zaměřili na zrakovou ostrost a zorné pole. U všech nemocných bylo zjištěno poškození obou zrakových funkcí. Zraková ostrost byla snížena v rozmezí 0,8 až pohyb před okem. Centrální skotom byl pozorován u12 pacientů,u ostatních se vyskytovaly jiné poruchy zorného pole. U 24 nemocných došlo k plné úpravě zrakových funkcí v průběhu 6 měsíců. Všichni pacienti byli podrobně vyšetřeni pro potvrzení či vyloučení roztroušené sklerózy mozkomíšní (RSM). U pacientů bez známek RSM (15 pacientů) byli 3 z nich léčeni steroidy (dva dostávali pulsy methylprednisolonu i.v. a jeden perorální léčbu prednisonem na jiném pracovišti), ostatním byly ordinovány vitaminy. U pacientů s prokázanou RSM byla zahájena léčba tohoto onemocnění na Neurologické klinice LF a FN UK v Hradci Králové.
The authors present results of retrospective study of 25 patients with the first attack of acute optic neuritis followed at the Department of Ophthalmology, University Hospital Hradec Králové. Visual functions were deteriorated in all patients. Visual acuity was in range between 0.8 to hand movement. Central scotoma was present in 12 patients, other visual field patterns were seen in 13 patients. Complete recovery of visual functionswas observed in 24 patients during the six months. Patients were examined for signs of multiple sclerosis (MS). In the group without MS (15 patients) were three treated with steroids (2 received intravenous methylprednisolone and 1 oral prednison before referral to us), vitamins were administered to the others. The patients with provedMSwere managed at the Department of Neurology, University Hospital, Hradec Králové.
- MeSH
- dospělí MeSH
- imunoglobulin G krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- neurologické vyšetření MeSH
- roztroušená skleróza etiologie MeSH
- zánět zrakového nervu diagnóza etiologie farmakoterapie MeSH
- zraková ostrost MeSH
- zraková pole MeSH
- zrakové evokované potenciály MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
We examined the visual and cognitive functions of a 72-year-old subject, KP, who recovered his sight after 53 years of visual deprivation. We used visual evoked potentials (VEPs) to pattern-reversal and motion-onset stimuli and cognitive responses (ERPs) during the oddball paradigm to assess the effect of long-term deprivation on a mature visual system. KP lost his sight at the age of 17 years, and light projection onto his right retina was restored at 71 years by a corneal implant. Nine months after sight recovery we recorded reproducible responses to all examined stimuli. The response to pattern reversal contained two P100-like peaks with the later peak being dominant and significantly delayed (260 ms) when compared to the P100s of two control subjects, to whom the stimuli were adjusted in size and contrast to mimic KP's vision. KP's motion-onset VEPs to full-field and peripheral stimuli had a characteristic shape with a well-defined N2 peak; however, both peaks were significantly delayed (262 and 272 ms) compared to control responses. Unlike the P100 and N2 peaks, which represent sensory detection, the P3b/P300 component of the ERP to a target event in the oddball paradigm was not further delayed. In spite of degraded vision and sensory deprivation lasting 53 years, KP displayed reproducible responses to all reported stimuli. Long-term visual deprivation and retinal detachment degraded KP's visual sensory processing, assessed by pattern-reversal and motion-onset VEPs, whereas the cognitive processing of appropriate visual stimuli was not compromised.
- MeSH
- časové faktory MeSH
- kognice fyziologie MeSH
- lidé MeSH
- obnova funkce fyziologie MeSH
- senioři MeSH
- senzorické prahy fyziologie MeSH
- slepota patofyziologie MeSH
- vnímání pohybu fyziologie MeSH
- zraková percepce fyziologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- MeSH
- lidé MeSH
- obnova funkce fyziologie MeSH
- rehabilitace MeSH
- skotom rehabilitace MeSH
- testy zrakového pole využití MeSH
- zraková pole genetika MeSH
- zrakové dráhy fyziologie patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- hodnotící studie MeSH
- MeSH
- adenom fyziologie chirurgie komplikace MeSH
- dospělí MeSH
- endokrinní žlázy fyziologie MeSH
- hypogonadismus etiologie patofyziologie MeSH
- hypotyreóza etiologie patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- nádory hypofýzy chirurgie komplikace patofyziologie MeSH
- prolaktin analýza metabolismus MeSH
- senioři MeSH
- zrak genetika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
Autoři se zabývají přínosem operace katarakty pro pacienty starší 80 let. V práci byla sledována korigovaná zraková ostrost (KZO) před operací, KZO 1. pooperační den a 6 a 18 měsíců po výkonu, kdy pacienti zároveň vyplnili dotazník subjektivního vnímání operace (dotazník VF-8). Tento krátký test hodnotí pomocí 8 otázek ? zaměřených na běžné situace ?vliv zákroku na kvalitu života. Prokázali jsme přínos operace šedého zákalu pro pacienty věkové skupiny nad 80 let. U většiny operovaných došlo nejen ke zlepšení zrakových funkcí, ale zlepšila se zejména jejich celková orientovanost, schopnost alespoň zčásti samostatně existovat, což znamená možnost hodnotnějšího prožití zbytku života často polymorbidních pacientů, a to i v dlouhodobém sledování 18 měsíců po výkonu. Proto u těchto nemocných pokládáme operaci katarakty za plně indikovanou, a to i v případě jiných mnohočetných onemocnění či imobility.
- MeSH
- finanční podpora výzkumu jako téma MeSH
- katarakta terapie MeSH
- komorbidita MeSH
- kvalita života psychologie MeSH
- lidé MeSH
- obnova funkce fyziologie MeSH
- oftalmologické chirurgické výkony využití MeSH
- průzkumy a dotazníky využití MeSH
- senioři nad 80 let MeSH
- Check Tag
- lidé MeSH
- senioři nad 80 let MeSH
PURPOSE: The implantation of an intraocular telescope increases life quality in patients with end-stage age-related macular degeneration (AMD). The present study monitored changes in electrophysiological markers of visual processing before and during seventeen months after a novel mirror telescope implantation in two patients (OV-male 90 years, MZ-female 70 years) with the final-stage form of AMD. METHODS: Visual evoked potentials were recorded to high-contrast pattern-reversal (PR-VEP for check size 40' and 10'), low-contrast motion-onset stimuli (in visual periphery M-VEP M20°, and in central part M-VEP C8°), and event-related potentials (ERPs) in the oddball visual paradigm. RESULTS: MZ's more systematic responses showed attenuation and prolongation of the M-VEP M20° and the PR-VEP 40' immediately after the telescope implantation with a slow amplitude recovery with unchanged prolonged latency. The implantation completely eradicated the M-VEP C8° without any restoration. The PR-VEP 10' were not readable. Only a part of OV's PR-VEP 40' and M-VEP M20' were of a repeatable and expected morphology. These OV's VEPs were consistent with MZ's findings. The ERPs did not show any effect of implantation in both patients. Post-implantation visual acuity and reaction time overcame the pre-implantation levels. CONCLUSIONS: The mirror telescope preserved peripheral vision in contrast to classic telescopes; however, the telescope concurrently reduced the luminance of the magnified retinal image, which was likely responsible for the prolongation of the VEP latencies.
- MeSH
- čočky * MeSH
- lidé MeSH
- makulární degenerace * patofyziologie rehabilitace MeSH
- rozpoznávání obrazu fyziologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- teleskopy * MeSH
- zraková ostrost MeSH
- zraková percepce fyziologie MeSH
- zrakové evokované potenciály * MeSH
- zrakové protézy * normy MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The term homonymous hemianopia refers to visual impairment due to a post-chiasmatic brain lesion. Mammalian neurons of the central nervous system do not have the ability to regenerate. However, the cerebral cortex shows plasticity in certain cases. Motor or speech disorders due to frontal lobe brain damage can be improved with well-directed rehabilitation techniques. If such plasticity is possible, it raises the question whether specialized training could improve a cortical visual disorder. There is need for simple visual training which could be used in rehabilitation. A few different approaches have been developed to treat patients with hemianopia: (1) substitution including special devices, such as optical prisms; (2) compensation using intact residual abilities - especially training of eye movements; (3) restitution which is based on stimulating the blind hemifield. The third method of rehabilitation is the most controversial; however, it has the largest potential. To support concepts of the targeted rehabilitation outlined here, first: further development of the theory of plasticity in visual pathways is required and second: the efficacy of the rehabilitation procedures has to be demonstrated by clinical evidence. We review methods and approaches of hemianopia rehabilitation and treatment. We also review results of contemporary clinical studies and meta-studies.
UNLABELLED: Single cases may lead to unexpected hypotheses in psychology. We retrospectively analyzed single case studies that suggested organizational principles along the early visual pathway, which have remained unanswered until now. FIRST CASE: In spite of the inhomogeneity of sensitivity, paradoxically the visual field on the subjective level appears to be homogeneous; constancy of brightness of supra-threshold stimuli throughout the visual field is claimed to be responsible for homogeneity; specific summation properties of retinal ganglion cells are hypothesized to guarantee this effect. SECOND CASE: With a brain-injured patient having suffered a partial visual field loss it can be shown that color induction is a retinal phenomenon; lateral inhibitory processes at the level of amacrine cells are hypothesized as neural network. Third case: In a patient having suffered a bilateral occipital lobe infarction, some functional recovery has been demonstrated; divergence and convergence of projection in the ascending neural pathway are suggested as a structural basis for recovery. Slowed down binocular rivalry discloses a sequential mechanism in the construction of a visual percept. Fourth case: The pre-wired projection of the retina to the visual cortex in spite of a severe squint of one eye is confirmed, but paradoxically some local neuroplasticity is also suggested. Fifth case: Using habituation of local sensitivity in the visual field and its resetting by interhemispheric interactions as an experimental paradigm, it is suggested that spatial attention is controlled at the midbrain level. Sixth case: Observations on residual vision or "blindsight" support the hypothesis that the visual cortex is the one and only structure responsible for visual perception on a conscious level. The unifying principle of these retrospective analyses is that subjective visual phenomena can lead to unexpected but testable hypotheses of neural processing on the structural and functional level in the early visual pathway.
- MeSH
- lidé MeSH
- metathalamus fyziologie MeSH
- mozkový infarkt patofyziologie MeSH
- poranění mozku patofyziologie MeSH
- pozornost fyziologie MeSH
- retina fyziologie MeSH
- retrospektivní studie MeSH
- slepota patofyziologie MeSH
- světelná stimulace MeSH
- vnímání barev MeSH
- zraková pole * MeSH
- zrakové dráhy fyziologie MeSH
- zrakové korové centrum fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Visual-evoked potentials (VEPs) were used for objective testing of visual functions during treatment courses of Lyme neuroborreliosis (LNB) in adult patients in the Czech Republic. In 30 LNB patients with originally delayed VEP latencies, pattern-reversal (R-VEP) and motion onset (M-VEP) VEPs were repeatedly examined within 1 to 8 years. Six patients had Lyme optic neuritis (ON), five of them displayed prolonged latencies in both R-VEPs and M-VEPs, and one had only abnormal R-VEPs. The VEP recovery to normal latency values was in three of them. In the group of 24 LNB patients without ON, 14 patients displayed prolonged latencies only to motion stimuli, and 10 patients had abnormal latencies in both R-VEPs and M-VEPs. During the follow-up period, 7 patients displayed shortening to normal latencies. In 5 patients, VEPs latencies improved only partially, and in the remaining 12 patients, VEPs did not improve at all. This study provides objective evidence that in LNB, most of the patients without clinically manifesting ON display optic pathway involvement-predominantly magnocellular system/dorsal stream function changes. In patients with ON, however, mainly the parvocellular system is affected. About half of the patients without ON improved with a relatively long-time course of latency shortening.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymská neuroborelióza komplikace patofyziologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- následné studie MeSH
- poruchy zraku etiologie patofyziologie MeSH
- senioři MeSH
- zrakové evokované potenciály fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
