Assessment of visual field defects in cerebrovascular disease (CVD)

To expedite the rehabilitation process of CVD patients, it becomes imperative to identify and assess the extent of the Visual Field defect and the type of CVD. Through this study we aim to assess the visual field loss in patients following Cerebrovascular disease (CVD) and correlate the site and vessel involved with the Visual Field Loss. The study is a cross sectional study carried out over 3 months. All patients with anterior or posterior circulation stroke irrespective of the cause at 2 weeks following the episode of stroke formed a part of this study. They underwent a thorough ophthalmological assessment and Visual Field Assessment. Also, the corresponding radiological data was analysed for the site and the vessels involved in the CVD and correlated with the visual field defect obtained. A total of 25 patients were assessed with 88% being male and 12% female. Common co-morbidities were ischemic heart disease (IHD), diabetes mellitus (DM) and hypertension (HTN). Here, 100% of the patients with IHD had visual field loss as a symptom (P=0.032). All the patients who had gait abnormalities and giddiness as complaints were found to present primarily with visual field defect (P=0.032). When the Posterior Cerebral Artery (PCA) was involved visual field defect was seen in 100% of the patients (Left PCA, P=0.032) and in 60% of patients with Right PCA involvement (P=0.133). Hundred percent of patients with Right occipital lobe involvement had a visual field defect (P=0.032). PCA involvement with the Left Lower temporal field loss and also MCA involvement with Right nasal fields were found to correlate significantly (P= 0.015, 0.022, 0.023 respectively). Hence, incorporating Ophthalmological assessment in all patients of stroke helps in rehabilitation of the patients better and at the earliest.