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Visual field defects after missile injuries to the geniculo-striate pathway in man

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Visual fields (defined by detection thresholds for moving and stationary targets) were examined in 10 cases of homonymous field defects due to retrochiasmal lesions. Using the Tübingen Perimeter, results of multiple perimetric methods could be compared quantitatively at identical retinal areas. The principal finding was one of thorough-going association of deficits: no instances of selective impairment of motion detection, flicker resolution, or regional dark adaptation were encountered. Pupillary reactivity to low-intensity light was depressed in areas of homonymous scotoma, as long as care was taken to avoid stimulation of relatively more intact regions of the visual field by scattered light. In the only case showing extreme difficulties in visual recognition (“agnosia”) for faces and objects there were unusually severe reductions in differential light detection thresholds, and in all other “elementary” visual functions. One half of the cases showed small homonymous scotomata with a sharp decrease of light sensitivity. They were often located in a perifoveal region that was otherwise normal. Field defects bordering on the midvertical meridian followed this meridian closer and tended to have steeper borders than those bordering on the midhorizontal meridian. Sparing of foveal vision (averaging 1.5°) was the rule but the spared region had reduced sensitivity. “Splitting” of the fovea was found in one case. Incongruence of homonymous field defects was greater for peripheral defects than for those near the center of the field; usually nasal fields showed larger defects than temporal. This tendency was enhanced by the sparing of parts of the monocular crescent in three cases.

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  1. Bay, E.: Agnosie und Funktionswandel; eine hirnpathologische Studie. Berlin-Göttingen-Heidelberg: Springer 1950.

  2. Best, W.: Die Abhängigkeit der Flimmerfrequenz von der Reizflächengröße und dem Ort der gereizten Netzhautstelle unter besonderer Berücksichtigung der Sehwellenreizlichtstärke. Albrecht v. Graefes Arch. klin. Ophthal. 152, 99–110 (1951).

  3. Bresky, R.H., Charles, S.: Pupil motor perimetry. Amer. J. Ophthal. 68, 108–112 (1969).

  4. van Buren, J.M.: Trans-synaptic retrograde degeneration in the visual system of primates. J. Neurol. Neurosurg. Psychiat. 26, 402–409 (1963).

  5. Dubois-Poulsen, A.: Le Champ Visuel. Paris: Masson et Cie 1952.

  6. Duke-Elder, S.: System of Ophthalmology. Vol. XII. Neuro-Ophthalmology. London: Kimpton 1971.

  7. Förster, R.: Über Gesichtsfeldmessungen. Klin. Mbl. Augenheilk. 5, 293–294 (1867).

  8. Frydrychowicz, G., Harms, H.: Ergebnisse pupillomotorischer Untersuchungen bei Gesunden und Kranken. Verh. dtsch. Ophthal. Ges. 53, 71–79 (1940).

  9. Goldman, P.S., Lodge, A., Hammer, L.R., Semmes, J., Mishkin, M.: Critical flicker frequency after unilateral temporal lobectomy in man. Neuropsychologia 6, 355–363 (1968).

  10. Harms, H.: Hemianopische Pupillenstarre. Klin. Mbl. Augenheilk. 118, 133–147 (1951).

  11. —: das menschliche Auge als Photometer. In: Coloquio sobre problemas ópticos de la vision. II; pp. 1–11. Madrid: C. Bermejo 1953.

  12. —: Diagnostische Bedeutung der Gesichtsfelduntersuchung. In: W. Rohrschneider (ed.). Augenheilkunde in Klinik und Praxis. Stuttgart: Enke 1958.

  13. —: Die Bedeutung einer einheitlichen Prüfweise aller Sehfunktionen. Verh. dtsch. Ophthal. Ges. 63, 281–285 (1960).

  14. - Visuelle und pupillomotorische Störungen bei Veränderungen des Occipitallappens. Proc. 8th Inter. Congr. Neurol., Vol. S, 57–78 (1965).

  15. —: Die Technik der statischen Perimetrie. Ophthalmologica (Basel) 158, 387–405 (1969).

  16. —, Raabe, M.: Besondere perimetrische Methoden bei ophthalmo-neurologischen Erkrankungen. Oesterr. Ophthal. Ges. 5, 1–13 (1960).

  17. Harms, H., Aulhorn, E., Ksinsik, R.: Die Ergebnisse pupillomotorischer Perimetrie bei Sehhirnverletzungen und die Vorstellung über den Verlauf der Sehbahn. Verh. dtsch. Ophthal. Ges. (in press).

  18. Huber, A.: Homonymous hemianopia after removal of one occipital lobe. Exc. Med. Inter. Congr. Ser. (ophthalmology) 222, 1333–1338 (1970).

  19. Koerner, F., Regli, H., Haynal, H.: Eine durch Farbsinnstörung, Prosopagnosie und Orientierungsstörung charakterisierte visuelle Agnosie. Arch. Psychiat. Nervenkr. 209, 1–20 (1967).

  20. Krieger, H.P.: Effect of retrochiasmal lesion upon variability of the absolute threshold. Arch. Neurol. (Chic.) 70, 70–76 (1953).

  21. —, Bender, M.B.: Dark adaptation in perimetrically blind fields. Arch. Ophthal. 46, 625–636 (1951).

  22. Lund, O.E., Peters, H.: Über Funktionsausfälle nach Hemisphärektomie. Verh. dtsch. Ophthal. Ges. 66, 264–271 (1964).

  23. Marino, R., Rasmussen, T.: Visual field changes after temporal lobectomy in man. Neurology 18, 825–835 (1968).

  24. Østerberg, G.: Topography of the layer of rods and cones in the human retina. Acta ophthal. (Kbh.) Suppl. 6, 1–102 (1935).

  25. Polyak, S.: The Vertebrate Visual System. H. Klüver (ed.). Chicago: Univ. of Chicago Press 1957.

  26. Rønne, H.: Über die Bedeutung der makularen Aussparung im hemianoptischen Gesichtsfelde. Klin. Mbl. Augenheilk. 49/2, 289–312 (1911).

  27. Sloan, L.L.: Instruments and techniques for the clinical testing of light sense. III. Arch. Ophthal. 22, 233–251 (1939).

  28. Spalding, J.M.K.: Wounds of the visual pathway. I. The visual radiation. J. Neurol. Neurosurg. Psychiat. 15, 99–109 (1952a).

  29. —: Wounds of the visual pathway. II. The striate cortex. J. Neurol. Neurosurg. Psychiat. 15, 169–183 (1952b).

  30. Sprague, J.M.: Interaction of cortex and superior colliculus in mediation of visually guided behavior in the cat. Science 153, 1544–1547 (1966).

  31. Szentágothai, J.: Die innere Gliederung des Oculomotoriuskernes. Arch. Psychiat. 115, 127–135 (1942).

  32. Teuber, H.L., Battersby, W.S., Bender, M.B.: Visual field defects after penetrating missile wounds of the brain. Cambridge: Harvard University Press 1960.

  33. Ullrich, N.: Adaptationsstörungen bei Sehhirnverletzten. Dtsch. Z. Nervenheilk. 155, 1–31 (1943).

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Work was supported in part by grants to Dr. F. Koerner, Tübingen, from Foundation Fund of Research in Psychiatry (FFRP grant G 69-447) and by grants to Professor H.-L. Teuber, M.I.T., from the Alfred P. Sloan Foundation, from NASA (NGR-22-009-308), and from the National Institute of Mental Health under a program grant, MH-05673. The follow-up examinations of patients in this study were facilitated by NIH-Clinical Research Center grant FR-88, to M.I.T.

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Koerner, F., Teuber, H. Visual field defects after missile injuries to the geniculo-striate pathway in man. Exp Brain Res 18, 88–113 (1973). https://doi.org/10.1007/BF00236558

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Key words

  • Visual field
  • Brain injury
  • Visual agnosia
  • Pupillomotor perimetry
  • Flicker fusion
  • Perimetric methods