Early clinical and subclinical visual evoked potential and Humphrey's visual field defects in cryptococcal meningitis
Cryptococcal induced visual loss is a devastating complication in survivors of cryptococcal meningitis (CM). Early detection is paramount in prevention and treatment. Subclinical optic nerve dysfunction in CM has not hitherto been investigated by electrophysiological means. We undertook a prospectiv...
Gespeichert in:
| Veröffentlicht in: | PloS one 2012-12, Vol.7 (12), p.e52895-e52895 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e52895 |
|---|---|
| container_issue | 12 |
| container_start_page | e52895 |
| container_title | PloS one |
| container_volume | 7 |
| creator | Moodley, Anand Rae, William Bhigjee, Ahmed Connolly, Cathy Devparsad, Natasha Michowicz, Andrew Harrison, Thomas Loyse, Angela |
| description | Cryptococcal induced visual loss is a devastating complication in survivors of cryptococcal meningitis (CM). Early detection is paramount in prevention and treatment. Subclinical optic nerve dysfunction in CM has not hitherto been investigated by electrophysiological means. We undertook a prospective study on 90 HIV sero-positive patients with culture confirmed CM. Seventy-four patients underwent visual evoked potential (VEP) testing and 47 patients underwent Humphrey's visual field (HVF) testing. Decreased best corrected visual acuity (BCVA) was detected in 46.5% of patients. VEP was abnormal in 51/74 (68.9%) right eyes and 50/74 (67.6%) left eyes. VEP P100 latency was the main abnormality with mean latency values of 118.9 (±16.5) ms and 119.8 (±15.7) ms for the right and left eyes respectively, mildly prolonged when compared to our laboratory references of 104 (±10) ms (p |
| doi_str_mv | 10.1371/journal.pone.0052895 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1327154469</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A477055763</galeid><doaj_id>oai_doaj_org_article_23239067b4cc4951b48681ca3c4e6bff</doaj_id><sourcerecordid>A477055763</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-d788377778ce5b5e9a26bd13e18c74b7da552a0c444e11526dcb0c4d2abe606d3</originalsourceid><addsrcrecordid>eNqNk11v0zAUhiMEYmPwDxBEQuLjoiW2Yzu5QZqmwSpNmsTXreXYJ62LY2dxUtF_j0vTqkG7ILnwR57znpzXPknyEmVzRDj6uPZD56Sdt97BPMsoLkr6KDlHJcEzhjPy-GR-ljwLYR0hUjD2NDnDBBcU4-w8Ga5lZ7epssYZJW0qnU7DUB3XGxOGOMDG_wKdtr4H15uRuxmadtXB9l04YLUBq1MNNag-pMalqtu2vVde7bQacMYtTW_C8-RJLW2AF-N4kfz4fP396mZ2e_dlcXV5O1OsxP1M86IgPD6FAlpRKCVmlUYEUKF4XnEtKcUyU3meA0IUM62quNJYVsAypslF8nqv21ofxOhYEIhgjmieszISiz2hvVyLtjON7LbCSyP-bvhuKWTXG2VBRNNImTFe5UrlJUVVXrACKUlUDqyq66j1acw2VA1oFa3qpJ2ITr84sxJLvxEkHh7PiijwfhTo_P0AoReNCQqslQ78EP8bc4J4rJlH9M0_6MPVjdRSxgKMq33Mq3ai4jLnPKOUMxKp-QNUfDU0RsXrVZu4Pwn4MAmITA-_-6UcQhCLb1__n737OWXfnrArkLZfBW-H3ngXpmC-B1XnQ-igPpqMMrHrjoMbYtcdYuyOGPbq9ICOQYd2IH8AmgcLcA</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1327154469</pqid></control><display><type>article</type><title>Early clinical and subclinical visual evoked potential and Humphrey's visual field defects in cryptococcal meningitis</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Moodley, Anand ; Rae, William ; Bhigjee, Ahmed ; Connolly, Cathy ; Devparsad, Natasha ; Michowicz, Andrew ; Harrison, Thomas ; Loyse, Angela</creator><contributor>Xue, Chaoyang</contributor><creatorcontrib>Moodley, Anand ; Rae, William ; Bhigjee, Ahmed ; Connolly, Cathy ; Devparsad, Natasha ; Michowicz, Andrew ; Harrison, Thomas ; Loyse, Angela ; Xue, Chaoyang</creatorcontrib><description>Cryptococcal induced visual loss is a devastating complication in survivors of cryptococcal meningitis (CM). Early detection is paramount in prevention and treatment. Subclinical optic nerve dysfunction in CM has not hitherto been investigated by electrophysiological means. We undertook a prospective study on 90 HIV sero-positive patients with culture confirmed CM. Seventy-four patients underwent visual evoked potential (VEP) testing and 47 patients underwent Humphrey's visual field (HVF) testing. Decreased best corrected visual acuity (BCVA) was detected in 46.5% of patients. VEP was abnormal in 51/74 (68.9%) right eyes and 50/74 (67.6%) left eyes. VEP P100 latency was the main abnormality with mean latency values of 118.9 (±16.5) ms and 119.8 (±15.7) ms for the right and left eyes respectively, mildly prolonged when compared to our laboratory references of 104 (±10) ms (p<0.001). Subclinical VEP abnormality was detected in 56.5% of normal eyes and constituted mostly latency abnormality. VEP amplitude was also significantly reduced in this cohort but minimally so in the visually unimpaired. HVF was abnormal in 36/47 (76.6%) right eyes and 32/45 (71.1%) left eyes. The predominant field defect was peripheral constriction with an enlarged blind spot suggesting the greater impact by raised intracranial pressure over that of optic neuritis. Whether this was due to papilloedema or a compartment syndrome is open to further investigation. Subclinical HVF abnormalities were minimal and therefore a poor screening test for early optic nerve dysfunction. However, early optic nerve dysfunction can be detected by testing of VEP P100 latency, which may precede the onset of visual loss in CM.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0052895</identifier><identifier>PMID: 23285220</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abnormalities ; Acquired immune deficiency syndrome ; Acuity ; Adolescent ; Adult ; AIDS ; Asymptomatic Diseases - epidemiology ; Automation ; Care and treatment ; Cohort Studies ; Compartment syndrome ; Cryptococcal meningitis ; Cryptococcus neoformans ; Defects ; Early Diagnosis ; Evoked Potentials, Visual - physiology ; Eye (anatomy) ; Feasibility studies ; Female ; Fungal infections ; Health screening ; HIV ; Hospitals ; Human immunodeficiency virus ; Humans ; Infections ; Intracranial pressure ; Latency ; Male ; Medical research ; Medicine ; Meningitis ; Meningitis, Cryptococcal - complications ; Meningitis, Cryptococcal - epidemiology ; Meningitis, Cryptococcal - physiopathology ; Middle Aged ; Neuritis ; Neurology ; Optic nerve ; Optic neuritis ; Pathogenesis ; Patients ; Swelling ; Vision Disorders - diagnosis ; Vision Disorders - epidemiology ; Vision Disorders - etiology ; Vision Disorders - physiopathology ; Visual acuity ; Visual evoked potentials ; Visual field ; Visual Field Tests ; Visual fields ; Visual Fields - physiology ; Young Adult</subject><ispartof>PloS one, 2012-12, Vol.7 (12), p.e52895-e52895</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Moodley et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2012 Moodley et al 2012 Moodley et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-d788377778ce5b5e9a26bd13e18c74b7da552a0c444e11526dcb0c4d2abe606d3</citedby><cites>FETCH-LOGICAL-c692t-d788377778ce5b5e9a26bd13e18c74b7da552a0c444e11526dcb0c4d2abe606d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528708/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528708/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23285220$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Xue, Chaoyang</contributor><creatorcontrib>Moodley, Anand</creatorcontrib><creatorcontrib>Rae, William</creatorcontrib><creatorcontrib>Bhigjee, Ahmed</creatorcontrib><creatorcontrib>Connolly, Cathy</creatorcontrib><creatorcontrib>Devparsad, Natasha</creatorcontrib><creatorcontrib>Michowicz, Andrew</creatorcontrib><creatorcontrib>Harrison, Thomas</creatorcontrib><creatorcontrib>Loyse, Angela</creatorcontrib><title>Early clinical and subclinical visual evoked potential and Humphrey's visual field defects in cryptococcal meningitis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Cryptococcal induced visual loss is a devastating complication in survivors of cryptococcal meningitis (CM). Early detection is paramount in prevention and treatment. Subclinical optic nerve dysfunction in CM has not hitherto been investigated by electrophysiological means. We undertook a prospective study on 90 HIV sero-positive patients with culture confirmed CM. Seventy-four patients underwent visual evoked potential (VEP) testing and 47 patients underwent Humphrey's visual field (HVF) testing. Decreased best corrected visual acuity (BCVA) was detected in 46.5% of patients. VEP was abnormal in 51/74 (68.9%) right eyes and 50/74 (67.6%) left eyes. VEP P100 latency was the main abnormality with mean latency values of 118.9 (±16.5) ms and 119.8 (±15.7) ms for the right and left eyes respectively, mildly prolonged when compared to our laboratory references of 104 (±10) ms (p<0.001). Subclinical VEP abnormality was detected in 56.5% of normal eyes and constituted mostly latency abnormality. VEP amplitude was also significantly reduced in this cohort but minimally so in the visually unimpaired. HVF was abnormal in 36/47 (76.6%) right eyes and 32/45 (71.1%) left eyes. The predominant field defect was peripheral constriction with an enlarged blind spot suggesting the greater impact by raised intracranial pressure over that of optic neuritis. Whether this was due to papilloedema or a compartment syndrome is open to further investigation. Subclinical HVF abnormalities were minimal and therefore a poor screening test for early optic nerve dysfunction. However, early optic nerve dysfunction can be detected by testing of VEP P100 latency, which may precede the onset of visual loss in CM.</description><subject>Abnormalities</subject><subject>Acquired immune deficiency syndrome</subject><subject>Acuity</subject><subject>Adolescent</subject><subject>Adult</subject><subject>AIDS</subject><subject>Asymptomatic Diseases - epidemiology</subject><subject>Automation</subject><subject>Care and treatment</subject><subject>Cohort Studies</subject><subject>Compartment syndrome</subject><subject>Cryptococcal meningitis</subject><subject>Cryptococcus neoformans</subject><subject>Defects</subject><subject>Early Diagnosis</subject><subject>Evoked Potentials, Visual - physiology</subject><subject>Eye (anatomy)</subject><subject>Feasibility studies</subject><subject>Female</subject><subject>Fungal infections</subject><subject>Health screening</subject><subject>HIV</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infections</subject><subject>Intracranial pressure</subject><subject>Latency</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Meningitis</subject><subject>Meningitis, Cryptococcal - complications</subject><subject>Meningitis, Cryptococcal - epidemiology</subject><subject>Meningitis, Cryptococcal - physiopathology</subject><subject>Middle Aged</subject><subject>Neuritis</subject><subject>Neurology</subject><subject>Optic nerve</subject><subject>Optic neuritis</subject><subject>Pathogenesis</subject><subject>Patients</subject><subject>Swelling</subject><subject>Vision Disorders - diagnosis</subject><subject>Vision Disorders - epidemiology</subject><subject>Vision Disorders - etiology</subject><subject>Vision Disorders - physiopathology</subject><subject>Visual acuity</subject><subject>Visual evoked potentials</subject><subject>Visual field</subject><subject>Visual Field Tests</subject><subject>Visual fields</subject><subject>Visual Fields - physiology</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11v0zAUhiMEYmPwDxBEQuLjoiW2Yzu5QZqmwSpNmsTXreXYJ62LY2dxUtF_j0vTqkG7ILnwR57znpzXPknyEmVzRDj6uPZD56Sdt97BPMsoLkr6KDlHJcEzhjPy-GR-ljwLYR0hUjD2NDnDBBcU4-w8Ga5lZ7epssYZJW0qnU7DUB3XGxOGOMDG_wKdtr4H15uRuxmadtXB9l04YLUBq1MNNag-pMalqtu2vVde7bQacMYtTW_C8-RJLW2AF-N4kfz4fP396mZ2e_dlcXV5O1OsxP1M86IgPD6FAlpRKCVmlUYEUKF4XnEtKcUyU3meA0IUM62quNJYVsAypslF8nqv21ofxOhYEIhgjmieszISiz2hvVyLtjON7LbCSyP-bvhuKWTXG2VBRNNImTFe5UrlJUVVXrACKUlUDqyq66j1acw2VA1oFa3qpJ2ITr84sxJLvxEkHh7PiijwfhTo_P0AoReNCQqslQ78EP8bc4J4rJlH9M0_6MPVjdRSxgKMq33Mq3ai4jLnPKOUMxKp-QNUfDU0RsXrVZu4Pwn4MAmITA-_-6UcQhCLb1__n737OWXfnrArkLZfBW-H3ngXpmC-B1XnQ-igPpqMMrHrjoMbYtcdYuyOGPbq9ICOQYd2IH8AmgcLcA</recordid><startdate>20121221</startdate><enddate>20121221</enddate><creator>Moodley, Anand</creator><creator>Rae, William</creator><creator>Bhigjee, Ahmed</creator><creator>Connolly, Cathy</creator><creator>Devparsad, Natasha</creator><creator>Michowicz, Andrew</creator><creator>Harrison, Thomas</creator><creator>Loyse, Angela</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20121221</creationdate><title>Early clinical and subclinical visual evoked potential and Humphrey's visual field defects in cryptococcal meningitis</title><author>Moodley, Anand ; Rae, William ; Bhigjee, Ahmed ; Connolly, Cathy ; Devparsad, Natasha ; Michowicz, Andrew ; Harrison, Thomas ; Loyse, Angela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-d788377778ce5b5e9a26bd13e18c74b7da552a0c444e11526dcb0c4d2abe606d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abnormalities</topic><topic>Acquired immune deficiency syndrome</topic><topic>Acuity</topic><topic>Adolescent</topic><topic>Adult</topic><topic>AIDS</topic><topic>Asymptomatic Diseases - epidemiology</topic><topic>Automation</topic><topic>Care and treatment</topic><topic>Cohort Studies</topic><topic>Compartment syndrome</topic><topic>Cryptococcal meningitis</topic><topic>Cryptococcus neoformans</topic><topic>Defects</topic><topic>Early Diagnosis</topic><topic>Evoked Potentials, Visual - physiology</topic><topic>Eye (anatomy)</topic><topic>Feasibility studies</topic><topic>Female</topic><topic>Fungal infections</topic><topic>Health screening</topic><topic>HIV</topic><topic>Hospitals</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infections</topic><topic>Intracranial pressure</topic><topic>Latency</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Meningitis</topic><topic>Meningitis, Cryptococcal - complications</topic><topic>Meningitis, Cryptococcal - epidemiology</topic><topic>Meningitis, Cryptococcal - physiopathology</topic><topic>Middle Aged</topic><topic>Neuritis</topic><topic>Neurology</topic><topic>Optic nerve</topic><topic>Optic neuritis</topic><topic>Pathogenesis</topic><topic>Patients</topic><topic>Swelling</topic><topic>Vision Disorders - diagnosis</topic><topic>Vision Disorders - epidemiology</topic><topic>Vision Disorders - etiology</topic><topic>Vision Disorders - physiopathology</topic><topic>Visual acuity</topic><topic>Visual evoked potentials</topic><topic>Visual field</topic><topic>Visual Field Tests</topic><topic>Visual fields</topic><topic>Visual Fields - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moodley, Anand</creatorcontrib><creatorcontrib>Rae, William</creatorcontrib><creatorcontrib>Bhigjee, Ahmed</creatorcontrib><creatorcontrib>Connolly, Cathy</creatorcontrib><creatorcontrib>Devparsad, Natasha</creatorcontrib><creatorcontrib>Michowicz, Andrew</creatorcontrib><creatorcontrib>Harrison, Thomas</creatorcontrib><creatorcontrib>Loyse, Angela</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moodley, Anand</au><au>Rae, William</au><au>Bhigjee, Ahmed</au><au>Connolly, Cathy</au><au>Devparsad, Natasha</au><au>Michowicz, Andrew</au><au>Harrison, Thomas</au><au>Loyse, Angela</au><au>Xue, Chaoyang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early clinical and subclinical visual evoked potential and Humphrey's visual field defects in cryptococcal meningitis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-12-21</date><risdate>2012</risdate><volume>7</volume><issue>12</issue><spage>e52895</spage><epage>e52895</epage><pages>e52895-e52895</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cryptococcal induced visual loss is a devastating complication in survivors of cryptococcal meningitis (CM). Early detection is paramount in prevention and treatment. Subclinical optic nerve dysfunction in CM has not hitherto been investigated by electrophysiological means. We undertook a prospective study on 90 HIV sero-positive patients with culture confirmed CM. Seventy-four patients underwent visual evoked potential (VEP) testing and 47 patients underwent Humphrey's visual field (HVF) testing. Decreased best corrected visual acuity (BCVA) was detected in 46.5% of patients. VEP was abnormal in 51/74 (68.9%) right eyes and 50/74 (67.6%) left eyes. VEP P100 latency was the main abnormality with mean latency values of 118.9 (±16.5) ms and 119.8 (±15.7) ms for the right and left eyes respectively, mildly prolonged when compared to our laboratory references of 104 (±10) ms (p<0.001). Subclinical VEP abnormality was detected in 56.5% of normal eyes and constituted mostly latency abnormality. VEP amplitude was also significantly reduced in this cohort but minimally so in the visually unimpaired. HVF was abnormal in 36/47 (76.6%) right eyes and 32/45 (71.1%) left eyes. The predominant field defect was peripheral constriction with an enlarged blind spot suggesting the greater impact by raised intracranial pressure over that of optic neuritis. Whether this was due to papilloedema or a compartment syndrome is open to further investigation. Subclinical HVF abnormalities were minimal and therefore a poor screening test for early optic nerve dysfunction. However, early optic nerve dysfunction can be detected by testing of VEP P100 latency, which may precede the onset of visual loss in CM.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23285220</pmid><doi>10.1371/journal.pone.0052895</doi><tpages>e52895</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2012-12, Vol.7 (12), p.e52895-e52895 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1327154469 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Abnormalities Acquired immune deficiency syndrome Acuity Adolescent Adult AIDS Asymptomatic Diseases - epidemiology Automation Care and treatment Cohort Studies Compartment syndrome Cryptococcal meningitis Cryptococcus neoformans Defects Early Diagnosis Evoked Potentials, Visual - physiology Eye (anatomy) Feasibility studies Female Fungal infections Health screening HIV Hospitals Human immunodeficiency virus Humans Infections Intracranial pressure Latency Male Medical research Medicine Meningitis Meningitis, Cryptococcal - complications Meningitis, Cryptococcal - epidemiology Meningitis, Cryptococcal - physiopathology Middle Aged Neuritis Neurology Optic nerve Optic neuritis Pathogenesis Patients Swelling Vision Disorders - diagnosis Vision Disorders - epidemiology Vision Disorders - etiology Vision Disorders - physiopathology Visual acuity Visual evoked potentials Visual field Visual Field Tests Visual fields Visual Fields - physiology Young Adult |
| title | Early clinical and subclinical visual evoked potential and Humphrey's visual field defects in cryptococcal meningitis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T06%3A25%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Early%20clinical%20and%20subclinical%20visual%20evoked%20potential%20and%20Humphrey's%20visual%20field%20defects%20in%20cryptococcal%20meningitis&rft.jtitle=PloS%20one&rft.au=Moodley,%20Anand&rft.date=2012-12-21&rft.volume=7&rft.issue=12&rft.spage=e52895&rft.epage=e52895&rft.pages=e52895-e52895&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0052895&rft_dat=%3Cgale_plos_%3EA477055763%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1327154469&rft_id=info:pmid/23285220&rft_galeid=A477055763&rft_doaj_id=oai_doaj_org_article_23239067b4cc4951b48681ca3c4e6bff&rfr_iscdi=true |