Pathak-Ray V, Ray A, Walters R, Hatfield R
Cardiff Eye Unit University Hospital of Wales Cardiff, UK.
Eye (Lond). 2002 Nov;16(6):744-8. doi: 10.1038/sj.eye.6700152.
The aim of this study is to quantify visual field defects after temporal lobectomy for mesial temporal sclerosis and to establish eligibility for driving.
Automated static perimetry was performed on 14 patients who had undergone anterior temporal lobectomy for mesial temporal sclerosis. Perimetry consisted of monocular Humphrey Field Analyser (HFA) 30-2 test and a binocular Esterman 120 test.
Of the 14 patients, three had no loss or non-specific loss, eight had partial homonymous quadrantanopia, one had complete homonymous quadrantanopia and two had concentric loss attributable to vigabatrin, which may have masked any loss occurring due to surgery. Of these, only seven passed the standardised DVLA visual fields. Of the seven who failed DVLA visual field, one had complete quadrantanopia, four had partial quadrantanopia and two had concentric loss (due to vigabatrin).
Visual field defects contribute a great deal in the reduction of the quality of life in patients who have had surgery for mesial temporal sclerosis. Potential surgically induced visual field defects that could preclude driving need to be discussed with each patient preoperatively. In our study 50% of patients did not meet the required DVLA standards.
本研究旨在量化内侧颞叶硬化患者颞叶切除术后的视野缺损情况，并确定其驾驶资格。
对14例因内侧颞叶硬化接受前颞叶切除术的患者进行自动静态视野检查。视野检查包括单眼Humphrey视野分析仪（HFA）30-2测试和双眼Esterman 120测试。
14例患者中，3例无视野缺损或有非特异性视野缺损，8例有部分同侧象限盲，1例有完全同侧象限盲，2例因服用vigabatrin出现同心性视野缺损，这可能掩盖了手术所致的任何视野缺损。其中，只有7例通过了标准化的英国驾驶员及车辆执照管理局（DVLA）视野检查。在未通过DVLA视野检查的7例患者中（因服用vigabatrin），1例有完全象限盲，4例有部分象限盲，2例有同心性视野缺损。
视野缺损对内侧颞叶硬化手术患者的生活质量有很大影响。术前需与每位患者讨论可能因手术导致的、妨碍驾驶的潜在视野缺损。在我们的研究中，50%的患者未达到DVLA要求的标准。
