Prognostic Factors for Long-Term Recovery of Homonymous Visual Field Defects After Posterior Circulation Ischemic Stroke |
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| Authors: | Cárdenas-Belaunzarán Jorge Cano-Nigenda Vanessa Barboza Miguel A González-Olhovich Irene Arauz Antonio |
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| Affiliation: | 1. Department of Neuro-Ophthalmology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico;2. Department of Neuro-Ophthalmology, Asociación para Evitar la Ceguera en México, I.A.P., Mexico City, Mexico;3. Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico;4. Neurosciences Department, Hospital Dr. Rafael A. Calderón Guardia, CCSS, San José, Costa Rica;5. Department of Neuro-Ophthalmology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico;6. Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico;7. Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico;1. Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama-shi, Tokyo 2068512, Japan;2. Department of Emergency and Critical Care Medicine, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Kawasaki-shi, Kanagawa 2118533, Japan;3. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan;4. Department of Neurosurgery, St. Luke''s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 1048560, Japan;5. Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 1138602, Japan;2. Division of Neurosurgery, University Surgical Cluster, National University Health System, Singapore;2. Department of Neurosurgery, NYU Langone Medical Center, New York, New York, USA;3. Department of Epidemiology and Neurology, Columbia University Irving Medical Center, New York, New York, USA;4. Department of Neurology, Brown University School of Medicine, Providence, RI, USA;2. Department of Cardiology, University of Campinas, UNICAMP, Campinas, SP, Brazil;3. Neuroimaging Laboratory, Department of Neurology, University of Campinas, UNICAMP, Campinas, SP, Brazil;4. Brazilian Institute of Neuroscience and Neurotechnology, BRAINN, at UNICAMP, Campinas, SP, Brazil;5. Department of Medical Psychology and Psychiatry, University of Campinas, UNICAMP, Campinas, SP, Brazil;1. Busan-Ulsan Regional Cardiocerebrovascular Center, Dong-A University Hospital, Busan, Republic of Korea;2. Department of Neurology, College of Medicine, Dong-A University, Busan, Republic of Korea |
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| Abstract: | ObjectivesIschemic stroke (IS) is the main cause of homonymous visual field defects (HVFDs) in adults. Some reports suggest recovery even in late-phase strokes, but data is sparse. This study examines the frequency of long-term recovery from HVFDs in patients with posterior circulation infarction (POCI) and evaluates whether demographic or clinical characteristics are prognostic factors of perimetric recovery.Materials and MethodsOur study included patients with HVFDS due to POCI who had undergone 2 or more kinetic perimetric evaluations at least 6 months after the index IS. Clinical and imaging data were systematically reviewed and we performed univariate and multivariate logistic regression analyses to determine whether demographic, stroke etiology (TOAST classification), and initial perimetric patterns were prognostic factors of visual recovery occurring 6 months and beyond from POCI.ResultsOne hundred one patients with POCI were included. Median subject age was 60 years and 54.4% were female. After a median perimetric follow-up time of 13.5 months, spontaneous visual improvement was observed in 15.8% of patients. Prognostic factors for visual improvement were age < 50 years (OR 4.6; P = 0.093), POCI associated with hypercoagulable states (OR 12.3; P = 0.048), and vertebral artery dissection (OR 12.6; P = 0.048), while the presence of complete homonymous hemianopia was a negative predictor of recovery (OR 0.2; P = 0.048).ConclusionPartial visual recovery in HVFDs is observed even 6 months and beyond POCI. Age < 50 years and stroke etiology were predictors of recovery. |
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