Department of Rehabilitation Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.
J Neurol Sci. 2022 Aug 15;439:120297. doi: 10.1016/j.jns.2022.120297. Epub 2022 May 27.
Visual field loss is associated with poor post-stroke functional outcomes. However, early detection of visual field loss is often challenging in patients with disabling stroke. This study explored the association between the microstructural integrity of the retrogeniculate pathway and visual field loss in disabling stroke patients undergoing inpatient rehabilitation. Thirty patients with stroke lesions involving the retrogeniculate visual pathway were included. The degree of visual field loss was determined by the visual field index and mean deviation using automated perimetry. The fractional anisotropy (FA) values were obtained for the lateral geniculate nucleus and optic radiation; the FA laterality indices, representing the degree of degeneration, were calculated. The FA values were compared between the affected and unaffected hemispheres. The patients were categorized into complete and incomplete hemianopia groups, and their FA values were compared. The relationship between the FA laterality index and the degree of visual field loss was assessed. FA values of the lateral geniculate nucleus and optic radiation were lower on the affected side than on the unaffected side (P < 0.001 and P < 0.001, respectively). The affected optic radiation in the complete hemianopia group showed a lower FA value than in the incomplete group (P = 0.006). The FA laterality index of the optic radiation was positively correlated with the degree of visual field loss (visual field index, ρ = 0.629; mean deviation, ρ = 0.568). The quantification of the retrogeniculate visual pathway may aid in detecting post-stroke visual field loss. The microstructural integrity of the optic radiation is associated with the severity of visual field loss.
视野缺损与中风后功能预后不良有关。然而，在患有致残性中风的患者中，早期发现视野缺损通常具有挑战性。本研究探讨了在接受住院康复治疗的致残性中风患者中，视放射(retrogeniculate pathway)的微观结构完整性与视野缺损之间的关系。纳入了 30 名中风病变累及视放射(retrogeniculate pathway)的患者。视野缺损程度通过视野指数和自动视野计的平均偏差来确定。获得外侧膝状体核和视放射的各向异性分数(FA)值；计算代表变性程度的 FA 侧性指数。比较受累侧和未受累侧的 FA 值。将患者分为完全性和不完全性偏盲组，并比较其 FA 值。评估 FA 侧性指数与视野缺损程度之间的关系。受累侧外侧膝状体核和视放射的 FA 值均低于未受累侧（P<0.001 和 P<0.001）。完全性偏盲组的受累视放射 FA 值低于不完全性组（P=0.006）。视放射的 FA 侧性指数与视野缺损程度呈正相关（视野指数，ρ=0.629；平均偏差，ρ=0.568）。视放射的微观结构完整性与视野缺损的严重程度有关。
