Ane Roushan Tharaldsen1, Kristin Modalsli Sand2,3, Ingvild Dalen4, Gunvor Wilhelmsen5, Halvor Naess2,6,7, Anna Midelfart8, Eyvind Rødahl2,9, Lars Thomassen2,7, Jana Midelfart Hoff7,10. 1. Department of Ophthalmology, Stavanger University Hospital, Norway, Stavanger. 2. Department of Clinical Medicine, University of Bergen, Norway, Bergen. 3. Department of Internal Medicine, Sørlandet Hospital Flekkefjord, Norway. 4. Section of Biostatistics, Department of Research, Stavanger University Hospital, Norway, Stavanger. 5. Faculty of Education, Department of Pedagogy in Teacher Education, Western Norway University of Applied Sciences, Bergen, Norway. 6. Centre for age-related medicine, Stavanger University Hospital, Norway, Stavanger. 7. Department of Neurology, Haukeland University Hospital, Bergen, Norway. 8. Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. 9. Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway. 10. VID Specialized University, Faculty of Health, Bergen, Norway.
Abstract
OBJECTIVES: The aim of this study was to detect visual field defects (VFD) after occipital infarction, investigate the rate of recovery and the impact of VFD upon vision related quality of life (QoL). MATERIALS & METHODS: Multicenter, prospective study including patients with MRI verified acute occipital infarction (NOR-OCCIP project). Ophthalmological examination including perimetry was performed within two weeks and after six months. Vision related QoL was assessed by the National Eye Institute Visual Function Questionnaire 25 (VFQ-25) at one and six months post stroke. RESULTS: We included 76 patients, reliable perimetry results were obtained in 66 patients (87%) at a median of eight days after admittance and VFD were found in 52 cases (79%). Evaluation of VFD after six months revealed improvement in 52%. Patients with VFD had significantly lower composite score in VFQ-25 at both test points (77 vs. 96, p=0.001 and 87 vs. 97, p=0.009), in nine out of eleven subscales of VFQ-25 at 1 month and seven subscales after 6 months, including mental health, dependency, near and distance activities. Milder VFD had better results on VFQ-25 modified composite score (95 vs. 74, p=0.002).VFD improvement was related to improved VFQ-25 modified composite score (9.6 vs. 0.8, p=0.018). 10% of patients with VFD reported driving one month post stroke and 38% after six months. CONCLUSION: VFD substantially reduces multiple aspects of vision related QoL. Severity of VFD is related to QoL and VFD improvement results in better QoL. Neglecting visual impairment after stroke may result in deterioration of rehabilitation efforts. Driving post stroke deserves particular attention. This article is protected by copyright. All rights reserved.
OBJECTIVES: The aim of this study was to detect visual field defects (VFD) after occipital infarction, investigate the rate of recovery and the impact of VFD upon vision related quality of life (QoL). MATERIALS & METHODS: Multicenter, prospective study including patients with MRI verified acute occipital infarction (NOR-OCCIP project). Ophthalmological examination including perimetry was performed within two weeks and after six months. Vision related QoL was assessed by the National Eye Institute Visual Function Questionnaire 25 (VFQ-25) at one and six months post stroke. RESULTS: We included 76 patients, reliable perimetry results were obtained in 66 patients (87%) at a median of eight days after admittance and VFD were found in 52 cases (79%). Evaluation of VFD after six months revealed improvement in 52%. Patients with VFD had significantly lower composite score in VFQ-25 at both test points (77 vs. 96, p=0.001 and 87 vs. 97, p=0.009), in nine out of eleven subscales of VFQ-25 at 1 month and seven subscales after 6 months, including mental health, dependency, near and distance activities. Milder VFD had better results on VFQ-25 modified composite score (95 vs. 74, p=0.002).VFD improvement was related to improved VFQ-25 modified composite score (9.6 vs. 0.8, p=0.018). 10% of patients with VFD reported driving one month post stroke and 38% after six months. CONCLUSION:VFD substantially reduces multiple aspects of vision related QoL. Severity of VFD is related to QoL and VFD improvement results in better QoL. Neglecting visual impairment after stroke may result in deterioration of rehabilitation efforts. Driving post stroke deserves particular attention. This article is protected by copyright. All rights reserved.
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Keywords:
Occipital infarction; quality of life; visual field defects