Un aspect fondamental du contrôle attentionnel réside dans la capacité du sujet à anticiper l’apparition d’un stimulus afin de rendre son traitement plus rapide et plus efficace. L'attention préparatoire (AP) est la capacité de moduler (rehausser) l’intensité de l’attention dirigée vers un stimulus sélectionné avant son apparition, en empêchant que le sujet soit distrait par une information non pertinente. Certaines études soutiennent que l’AP est latéralisée dans l’hémisphère droit (HD) alors que d’autres suggèrent que les deux hémisphères, l’hémisphère gauche (HG) et l’HD, sont impliqués dans la modulation de l’AP. L’objectif de cette thèse est d’analyser le rôle joué par chaque hémisphère cérébral dans la modulation de l’AP dirigée vers une localisation de l’espace. Nous avons développé une version latéralisée du test APT (pour Attentional Preparatory Test, proposé par LaBerge, Auclair & Siéroff, 2000), le LAPT (Lateralized Attentional Preparatory Test). L’APT permet de mesurer la capacité des sujets à moduler leur AP vers la localisation d’une cible lorsque la probabilité d'un distracteur varie selon plusieurs blocs d’essais. Dans l’APT, le temps de réponse augmentait lorsque la probabilité d’apparition d’un distracteur dans la phase préparatoire antérieure à la présentation de la cible augmentait, ce qui montre que l’AP est modulée par des évènements antérieurs au traitement de la cible. Nous avons créé le LAPT en utilisant la méthode de présentation en champ visuel divisé dans laquelle les stimuli peuvent apparaître dans le champ visuel gauche (CVG) ou dans le champ visuel droit (CVD). Les différences de performances entre champs visuels nous donnent des indications sur les stratégies de traitement des deux hémisphères (CVD/HG vs CVG/HD). Dans une série d’études, nous avons montré que la modulation de l’AP en fonction de la probabilité attendue d’un événement diffère dans chaque champ visuel/hémisphère en fonction de la configuration de la tâche. Dans le CVD/HG, l’AP est modulée par la probabilité des événements distracteurs, surtout quand cette probabilité est explicite. De plus, l’HG semble tenir un rôle crucial dans la modulation de l’AP quand la cible et le distracteur sont difficiles à discriminer. Dans le CVG/HD, l’AP est modulée par la probabilité temporelle des événements et dépendrait du délai le plus probable dans lequel la cible est attendue, mais seulement lorsque la discrimination entre la cible et le distracteur est plus facile. Enfin, nos résultats suggèrent que les différences entre le CVD/LH et le CVG/RH lors de cette modulation attentionnelle se mettent en place à un niveau perceptif du traitement de l’information car ils sont indépendants de la main utilisée pour répondre et donc des processus requis au niveau de la programmation motrice. L’ensemble de ces résultats suggère que chaque hémisphère utilise une stratégie différente pour moduler l’AP lorsqu’elle est dirigée vers une localisation de l’espace. / A crucial aspect of attentional control is the capacity of anticipating a stimulus appearance in order to improve the speed and effectiveness of its subsequent processing. Preparatory attention (PA) is the ability to modulate (enhance) the intensity of attention directed to a selected stimulus prior to its occurrence, preventing subjects from being distracted by interfering stimuli. Some studies propose that PA is lateralized to the right hemisphere (RH) while others suggest that both the left hemisphere (LH) and the RH participate in the modulation of PA. The aim of the present thesis was to examine the role of each brain hemisphere in the modulation of PA directed to a spatial location. We developed a lateralized version of the Attentional Preparatory Test, (APT, proposed par LaBerge, Auclair & Siéroff, 2000), named the Lateralized APT or LAPT. The APT measures the ability of subjects to modulate PA directed to a target location when the probability of a distractor occurrence varies across several blocks of trials. In the APT, the response times increased as the probability of a distractor appearing in the preparatory phase preceding the target presentation increased, showing that PA is modulated by the events occurring prior to the target appearance. We developed the LAPT using the divided visual field paradigm in which stimuli can occur in the left (LVF) or the right (RVF) visual fields. The visual field differences in subjects’ performance are assumed to reflect differences in the processing strategies of both hemispheres (RVF/LH vs LVF/RH). In a series of studies we showed that the modulation of PA by the expected probability of events was different in each visual field/hemisphere, depending on task configuration. In the RVF/LH, PA is modulated by the expected probability of distractor events, especially when this probability is explicit. In addition, the LH seems to play a crucial role in modulating PA when the target and the distractor are hard to discriminate. In the LVF/RH, PA is modulated by the temporal probability of events and may depend on the most probable delay in which the target is expected, but only when the discrimination between the target and the distractor is easy. Most importantly, our findings suggest that the differences between RVF/LH and LVF/RH in the modulation of PA take place at the perceptual level of processing because they are independent of the hand use in executing the response, thus also independent of the processes taking place at the motor programming level. Taken together our results, they suggest that each hemisphere uses a different strategy to modulate PA when directed to a spatial location.

Le vieillissement entraîne une dégradation des mécanismes sensoriels d’intégration pouvant se manifester dans les tâches de la vie quotidienne des seniors par une perte d'autonomie et des risques de chute. Parmi les facteurs contribuant à l’augmentation de ces risques, certains pourraient relever d’une dégradation de la (re)pondération des signaux sensoriels se traduisant par une augmentation de la dépendance aux informations visuelles et aux références spatiales associées.Examiner la dépendance au référentiel visuel (DRV) dans le contexte du vieillissement permet ainsi de mieux comprendre:• si des effets d’âge sur la cognition et/ou la sensorimotricité sont liés à l’augmentation de la DRV;• si la DRV majorée des seniors indique un mode préféré de référentiation spatiale ou une conséquence des déficits liés à l'âge;• l’évolution de ces associations et ces mécanismes en étudiant des jeunes adultes, des adultes d'âge intermédiaire et des seniors.Dans le Chapitre 2, nous avons examiné les facteurs associés à une plus grande DRV avec l'âge. Nous avons confirmé les résultats classiques de la littérature en montrant une augmentation de la DRV avec l’âge, de plus celle-ci était associée avec une réduction de i) l’effet Aubert, indiquant une réduction de la dépendance au référentiel égocentré (DRE), ii) la capacité de traitement d'attention visuelle parallèle, et iii) la stabilité de fixation visuelle.Nous avons étudié ensuite les comportements d’orientation et de stabilisation de nos participants pendant des tâches posturales, et de marche face à des flux optiques linéaires projetés au sol. Dans le Chapitre 3, nos participants se tenaient 1) en posture érigée pieds serrés ou 2) marchaient sur place (MSP - contacts podaux intermittents) face à 1- une stimulation visuelle statique, 2- un flux optique naturel (aucune stimulation), 3- en approche ou 4- en recul. Les flux optiques ont surtout influencé la MSP induisant des dérives antéroposterieures de la tête, du tronc et du centre de pression (CdP). Les dérives étaient plus marquées chez les seniors par rapport aux autres groupes. Ces participants ont aussi montré des dérives naturelles en condition de MSP, i.e. sans stimulation visuelle projetée. La direction du flux optique a provoqué les effets les plus importants sur la dérive du CdP en association avec i) une DRV supérieure, ii) une DRE réduite et iii) une plus grande dérive naturelle,Dans le chapitre 4, nous avons étudié l'influence de ces mêmes flux sur le contrôle des paramètres de la marche et sur la stabilisation de la tête au cours de la marche. La dépendance au cadre de référence visuel s’est manifestée chez les seniors dans les conditions de i) flux naturel par une stratégie d’abaissement de la tête et une capacité réduite de stabilisation de la tête sur l’espace dont on peut penser que ces comportements visaient à maximiser l’utilisation des indices visuels disponibles, et ii) flux visuels imposés, par une réorientation du tronc et une augmentation de la fréquence du pas. Les résultats montrent aussi une adoption plus fréquente de la stratégie de stabilisation de la tête sur l’espace en conditions imposées de stimulation visuelle. Ce résultat suggère qu’un renforcement artificiel du flux optique mène à une adaptation posturale permettant une meilleure intégration des informations sensorielles pendant la marche.Nos résultats complètent les connaissances actuelles sur les relations entre la DRV et le contrôle sensorimoteur en fonction de la tâche perceptivo- motrice avec l’âge. Cette dépendance semble être associée à une réduction de l'exploitation du cadre de référence égocentrée en termes de perception de l’orientation du corps/verticale et de mouvement- propre, et se manifeste différemment selon la tâche. Enfin, notre travail ouvre des pistes de réflexion pour tenir compte de la DRV exacerbée dans la conception de protocoles d’entraînement pour des seniors plus dépendants. / Aging entails deficits in the mechanisms of sensory integration which may affect daily living tasks in old adults, ultimately leading to loss of autonomy and health risks, notably falls. Among the factors contributing to these risks, some may be associated with a degradation in sensory (re)weighting, leading to a greater reliance on visual cues and the associated frames of reference (FoR) (visual field dependence).Our aim was to study how preferential modes of spatial referencing influence sensorimotor control. Examining visual field dependence in the context of aging thus allows to better understand:• if age-related cognition and/or sensorimotor deficits are associated with increased reliance on the visual FoR;• whether this reliance indicates a preferred mode of spatial referencing or a consequence of age-related deficits;• how the above associations and mechanisms evolve by studying young, middle-aged and old adults.We first examined possible factors associated with greater reliance on the visual FoR with age (Chapter 2). We confirmed classic literature reports of increased visual field dependence in old age, and uncovered an association between greater visual field dependence and reduced i) reliance on the egocentric FoR, ii) parallel attentional visual processing ability, and iii) visual fixation stability.We subsequently examined the orientation and stabilisation behaviour of our participants during postural tasks and while walking under different conditions of linear ground optic flow. In Chapter 3, participants stood quietly or stepped in place (SIP – intermittent podal contacts with the ground surface) while confronted with 1- natural optic flow (no stimulus), 2- a static visual stimulation, 3- approaching and 4- receding optic flow. The results showed that the optic flow stimuli influenced SIP primarily as evidenced by anteroposterior drifting of the head, trunk and centre of pressure (COP). Old adults had larger amplitudes of drift compared to the younger participants, and drifted even under natural flow (natural drift) during SIP, indicating reduced egocentric self-motion perception. The most important directional optic flow effects were on the COP and were associated with i) increased reliance on the visual FOR, ii) reduced reliance on the egocentric FoR, and iii) greater natural drift.In Chapter 4 we investigated the influence of ground optic flow on the control of walking and head stabilisation. Reliance on the visual FoR in old adults was manifested under conditions of i) natural flow by a reduced head pitch orientation and ability to stabilise their head in space, which may indicate a strategy to maximise the salience of available visual cues and ii) imposed optic flow, by a re-orientation of the trunk in pitch and increase in stepping frequency. Our results also revealed a general improvement of head stabilisation under conditions of imposed visual stimulation towards a more frequent adoption of the head stabilisation in space strategy. This suggests that the artificial enhancement of optic flow provokes a postural adaptation in order to optimise sensory information processing when walking.Our findings extend current knowledge on the association between reliance on the visual FoR and sensorimotor control across adulthood and depending on the perceptivo-motor task. It is evident that this reliance is linked to a reduction in the exploitation of the egocentric FoR in terms of body orientation and self-motion perception, and that its manifestation depends on the task. Finally, our work provides insights for the design of training protocols aimed at frailer olds taking into account exacerbated reliance on the visual FoR.

Recently, there has been a notable rise in the use of colored lighting for both indoor andoutdoor spaces. This trend necessitates a clear understanding of the principles behindselecting lighting levels that are both ergonomic and energy efficient. The objective ofthis study was to establish guidelines for planning colored light. An experiment wasconducted where the perceived brightness of three different near-monochromatic lightswere compared to white light. The stimuli covered a narrow visual field. 33 personsaged 18-40Y participated. Through the measurement of the participants' perception ofthe amount of colored light required -to achieve the same level of brightness as withwhite light- the study was able to determine a percentage-based relationship betweencolored and white light. The result showed that there were clear differences in theperceived brightness of the different colored lights, in line with earlier research withsimilar conditions. This implicates that the results may be used as a foundation whenplanning colored light.

This exploration is one artist's view of visual reasoning through the study of depth perception. The experiment searched for pre-architectural forms through an investigation of geometric rectangular shapes and planar figures in anticipation of finding architectural volumes, that is, three-dimensional objects. I used three parameters to observe: the expected or planned, the anticipated, and the unforeseen. The pre-architectural sketching style used the disciplines of painting, sculpture, graphic arts, color theory, optics, and photography to formulate an architectural language. First, as artist (painter), I selected the medium of light as the brushstroke, color as the pigment, and photographic film plane as the canvas to capture image abstractions. Second, I used one-point perspective as the viewer's line of sight. Finally, I employed a series of shape abstractions to form a succession of transparent sections that composed the subject matter. This experiment sought to analyze visual perception by capturing the spatial depth of images, that is, a reproduction of something sculptural in likeness. The challenge was to reintegrate the abstracted Rectangular Shapes and Planar Figures. In order to achieve this physical abstraction, I created a modified camera obscura. This exploration produced clearly defined images-as-products that were interpreted as pre-architectural forms, which allowed me to translate color abstractions into architectural form studies, or models-as-products. Thus, the experiment created architectural volumes using light and color in order to draw points, lines, planes, and spatial depth. / Master of Architecture

The loss of central vision subsequent to macular disease is often extremely debilitating. People with central field loss (CFL) must use other peripheral areas of the retina in order to see; areas with inferior resolution capacity, which are also affected by off-axis optical errors. The overall aim of the work encompassed by this thesis was to identify and evaluate methods of improving vision for people with CFL; with focus on the effects of off-axis optical correction and stimulus motion on resolution acuity and contrast sensitivity. Off-axis optical errors were measured using a commercially-available COAS-HD VR open-view aberrometer. We used adaptive psychophysical methods to evaluate grating resolution acuity and contrast sensitivity in the peripheral visual field; drifting gratings were employed to   measure the effect of motion on these two measures of visual performance. The effect of sphero-cylindrical correction and stimulus motion on visual performance in healthy eyes and in subjects with CFL was also studied; in addition, the effect of adaptive optics aberration correction was examined in one subject with CFL. The COAS-HD aberrometer provided rapid and reliable measurements of off-axis refractive errors. Correction of these errors gave improvements in low-contrast resolution acuity in subjects with higher amounts of oblique astigmatism. Optical correction also improved high-contrast resolution acuity in most subjects with CFL, but not for healthy subjects. Adaptive optics correction improved both high and low contrast resolution acuity in the preferred retinal locus of a subject with CFL. The effect of stimulus motion depended on spatial frequency; motion of 7.5 Hz improved contrast sensitivity for stimuli of low spatial frequency in healthy and CFL subjects. Motion of 15 Hz had little effect on contrast sensitivity for low spatial frequency but resulted in reduced contrast sensitivity for higher spatial frequencies in healthy subjects. Finally, high-contrast resolution acuity was relatively insensitive to stimulus motion in the periphery. This thesis has served to broaden the knowledge regarding peripheral optical errors, stimulus motion and their effects on visual function, both in healthy subjects and in people with CFL. Overall it has shown that correction of off-axis refractive errors is important for optimizing peripheral vision in subjects with CFL; the use of an open-view aberrometer simplifies the determination of these errors. In addition, moderate stimulus motion can have a beneficial effect on contrast sensitivity for objects of predominantly low spatial frequency.

OBJETIVO: Investigar a correlação entre as espessuras da mácula e da camada de fibras nervosas da retina (CFNR), medidas pelas tomografias de coerência óptica de domínio Fourier (FD - OCT) e de domínio do tempo (TD - OCT) e a perda de sensibilidade no campo visual (CV) em pacientes com atrofia em banda do nervo óptico. Comparar a habilidade diagnóstica dos dois instrumentos. MÉTODOS: 36 olhos de 36 pacientes com perda de CV permanente por compressão do quiasma óptico e 36 controles normais foram submetidos ao exame de CV pela perimetria automatizada padrão (Humphrey Field Analyzer TM; Carl Zeiss Meditec, Dublin, CA), ao FD - OCT (3 D OCT-1000TM Topcon Corp., Tokyo, Japan) e ao TD - OCT (StratusTM ;Carl Zeiss Meditec Inc, Dublin, California, USA). Foram comparados os protocolos análogos de ambos os equipamentos para avaliação da espessura macular.Foi realizado a divisão macular em quatro quadrantes e em metades, sendo calculado a média da espessura macular global, a média da espessura dos quadrantes e a média da espessura das metades maculares. A média global e setorial da medida da espessura da CFNR peripapilar também foi analisada. A perda de sensibilidade no CV foi inicialmente avaliada pelo defeito temporal médio. O CV foi ainda dividido em 6 setores de acordo com a distribuição da CFNR e em 16 pontos centrais para a realização da correlação estrutura-função entre os parâmetros medidos pelo FD - OCT e a perda de sensibilidade no CV em decibéis e 1/Lambert. Foi calculado o coeficiente de correlação de Sperman e a análise de regressão linear. As áreas sobre a curva ROC e valores fixos de sensibilidade e especificidade foram calculados para cada parâmetro estudado. RESULTADOS: As medidas da espessura macular e da CFNR pelo FD - OCT e TD - OCT foram capazes de discriminar olhos com atrofia em banda do nervo óptico dos controles normais. A espessura global e setorial dos parâmetros maculares e da CFNR mostraram diferenças significativas (p<0,001) entre os doentes e os controles e os dois aparelhos tiveram desempenho semelhante na discriminação entre pacientes e controles. Em ambos existiram correlações significativas entre a perda de sensibilidade do CV e as medidas da espessura macular e da CFNR. As medidas de espessura nos quadrantes e nas metades nasais da macula, avaliadas pelo FD - OCT tiveram os melhores desempenhos nas correlações com os defeitos de CV, sendo o parâmetro com a melhor correlação, a medida do quadrante infero-nasal da mácula e a perda de sensibilidade do CV central do quadrante temporal superior central (r = 0.78, R2 = 61%, p<0,001). CONCLUSÕES: A espessura macular e a espessura da CFNR medidas pelo FD - OCT e pelo TD - OCT se correlacionaram topograficamente com a perda de sensibilidade no CV de pacientes com hemianopsia temporal por compressäo quiasmática. A correlação entre os quadrantes maculares e a perda de sensibilidade no CV, foram melhores do que aquelas entre o CV e as medidas da CFNR, principalmente nas medidas realizadas pelo FD - OCT. Este estudo demonstrou a importância clínica das medidas maculares na correlação estrutura-função e na quantificaçäo do dano neural em pacientes com compressão quiasmática, podendo ser útil na monitorização destes pacientes / PURPOSE: To investigate the relationship between fourier-domain optical coherence tomography (FD - OCT) measured macular and retinal nerve fiber layer thickness (RNFL) and visual field sensitivity loss on standard automated perimetry in eyes with permanent temporal hemianopia from chiasmal compression and compare the ability of FD - OCT and time-domain optical coherence tomography (TD - OCT) to detect axonal loss in eyes with band atrophy of the optic nerve. METHODS: One eye of each of 36 patients with permanent temporal visual field defects and 36 age- and sex-matched healthy subjects. Subjects underwent standard automated perimetry and macular and RNFL thickness measurements with FD - OCT (3 D OCT-1000® Topcon Corp., Tokyo, Japan) and TD - OCT (Stratus; Carl Zeiss Meditec Inc, Dublin, California, USA). Macular thickness measurements as a global average, divided in four quadrants and in two halves as well as average and sectoral RNFL thickness around the optic disc were calculated. Visual field sensitivity loss was evaluated by the temporal mean defect; as deviations from normal in six sectors of the visual field and in 16 central visual field test points. Relationship between visual field sensitivity loss in decibel and 1/Lambert units and optical coherence tomography measurements were evaluated using Spearman correlation coefficients and by linear regression analysis. Receiver operating characteristic curves and sensitivities at fixed specificities were calculated for each parameter. RESULTS: Global and sectoral macular and RNFL thickness parameters showed a significant difference in eyes with band atrophy compared with controls. The strongest correlations were seen between visual field sensitivity loss and quadrantic or hemianopic nasal macular thickness measurements than with sectoral retinal nerve fiber layer thickness measurements. The highest correlation was observed between the inferonasal quadrant macular thickness and the visual field sensitivity loss in the superior temporal central visual field quadrant (r = 0.78, R2 = 61%, p <0.001). CONCLUSION: Both RNFL thickness and macular thickness FD - OCT and TD - OCT measurements were related topographically with visual field sensitivity loss in patients with temporal hemianopia from chiasmal compression and there is a stronger relationship in quadrantic macular compared to RNFL thickness measurements with FD - OCT. Macular thickness measurements could potentially be used to quantify neuronal loss in patients with chiasmal compression and could prove clinically useful for detection of damage and for monitoring these patients

OBJETIVO: Avaliar a capacidade do potencial visual evocado multifocal (PEV-mf) em diferenciar pacientes portadores de hemianopsia temporal de controles normais e avaliar a correlação entre o PEV-mf, o campo visual (CV) realizado com a perimetria automatizada e a tomografia de coerência óptica de domínio fourier (TCO-dF). MÉTODOS: Vinte sete olhos de 21 pacientes com defeito de campo visual temporal secundário a compressão quiasmática e 43 olhos de 23 controles normais foram submetidos aos exames PEV-mf, CV e TCO-dF (3D OCT-1000®, Topcon) da mácula e da camada de fibras nervosas da retina (CFNR). Foi calculada a média das respostas do PEV-mf global, do PEV-mf central e a média de espessura do TCO-dF da mácula para cada quadrante e para cada hemicampo, enquanto a espessura da CFNR foi dividida em 12 setores ao redor do nervo óptico. A perda de CV foi calculada para os quatro quadrantes e para os hemicampos temporal e nasal no CV 24-2 e CV 10-2. Os dois grupos foram comparados utilizando equações de estimativas generalizadas (GEE) e as correlações entre o PEV-mf, CV e o TCO-dF foram calculadas. RESULTADOS: As médias das amplitude P1 e N2 do PEV-mf global e central para os hemicampos e os quadrantes temporais foram significativamente menores nos pacientes que nos controles (p < 0.004). Não houve diferença estatística entre os grupos para os parâmetros de amplitudes do PEV-mf nos setores nasais. Não houve diferença estatística nas médias das latências do PEV-mf global e central entre os pacientes e os controles normais. Foi encontrada correlação moderada, estatisticamente significativa, entre os parâmetros de amplitudes temporais do PEV-mf - global e central com a perda de CV 24-2 e 10-2 temporal, assim como com as medidas de espessura macular e da espessura CFNR na TCO-dF. CONCLUSÕES: As médias das amplitudes do PEV-mf foram capazes de diferenciar olhos de pacientes com hemianopsia dos controles normais e apresentaram correlação significativa com os dados obtidos pela perimetria automatizada e pelo TCO-dF. Estes dados sugerem que o PEV-mf global e central podem ser utilizados na detecção de anormalidades do campo visual em pacientes portadores de compressão quiasmática / PURPOSE: To evaluate the ability of multifocal visual evoked potential (mfVEP) to differentiate patients with temporal hemianopia due to chiasmal compression from normal controls. To assess the relationship between mfVEP, standard automated perimetry (SAP) and fourier domain-optical coherence tomography (fd-OCT). METHODS: Twenty-seven eyes of 21 patients with permanent temporal visual field (VF) defects from chiasmal compression and 43 eyes of 23 healthy controls underwent mfVEP, SAP and fd-OCT (3D OCT-1000®, Topcon) macular and peripapillary retinal nerve fiber layer (RNFL) measurements. It was averaged the responses for global mfVEP, central mfVEP and fd-OCT macular measurements were averaged in quadrants and halves, while peripapillary RNFL thickness was averaged in 12 sectors around the disc. VF loss was estimated in four quadrants and each half of 24-2 and 10-2 strategy test points. The two groups were compared using generalized estimated equations (GEE). Correlations between mfVEP, VF and fd-OCT findings were verified. RESULTS: Global and central mfVEP P1 and N2 amplitude parameters of temporal measurements were significantly smaller in patients than controls (p < 0.004). No significant differences were observed between the groups with respect to mfVEP amplitude parameters from the nasal measurements. No significant differences were observed in global and central mfVEP latency parameters for all averaged measurements between patients and healthy controls. A significant moderate correlation was found between global and central mfVEP amplitude parameters of temporal measurements and temporal VF 24-2 and 10-2 loss as well as with corresponding fd-OCT macular and RNFL thickness measurements. CONCLUSIONS: mfVEP amplitude parameters were able to differentiate eyes with temporal hemianopia from controls and were significant correlated with VF and fd-OCT findings. These data suggest that it is a useful technology for detecting visual abnormalities in patients with chiasmal compression

No description available.

OBJETIVO: Avaliar a capacidade do potencial visual evocado multifocal (PEV-mf) em diferenciar pacientes portadores de hemianopsia temporal de controles normais e avaliar a correlação entre o PEV-mf, o campo visual (CV) realizado com a perimetria automatizada e a tomografia de coerência óptica de domínio fourier (TCO-dF). MÉTODOS: Vinte sete olhos de 21 pacientes com defeito de campo visual temporal secundário a compressão quiasmática e 43 olhos de 23 controles normais foram submetidos aos exames PEV-mf, CV e TCO-dF (3D OCT-1000®, Topcon) da mácula e da camada de fibras nervosas da retina (CFNR). Foi calculada a média das respostas do PEV-mf global, do PEV-mf central e a média de espessura do TCO-dF da mácula para cada quadrante e para cada hemicampo, enquanto a espessura da CFNR foi dividida em 12 setores ao redor do nervo óptico. A perda de CV foi calculada para os quatro quadrantes e para os hemicampos temporal e nasal no CV 24-2 e CV 10-2. Os dois grupos foram comparados utilizando equações de estimativas generalizadas (GEE) e as correlações entre o PEV-mf, CV e o TCO-dF foram calculadas. RESULTADOS: As médias das amplitude P1 e N2 do PEV-mf global e central para os hemicampos e os quadrantes temporais foram significativamente menores nos pacientes que nos controles (p < 0.004). Não houve diferença estatística entre os grupos para os parâmetros de amplitudes do PEV-mf nos setores nasais. Não houve diferença estatística nas médias das latências do PEV-mf global e central entre os pacientes e os controles normais. Foi encontrada correlação moderada, estatisticamente significativa, entre os parâmetros de amplitudes temporais do PEV-mf - global e central com a perda de CV 24-2 e 10-2 temporal, assim como com as medidas de espessura macular e da espessura CFNR na TCO-dF. CONCLUSÕES: As médias das amplitudes do PEV-mf foram capazes de diferenciar olhos de pacientes com hemianopsia dos controles normais e apresentaram correlação significativa com os dados obtidos pela perimetria automatizada e pelo TCO-dF. Estes dados sugerem que o PEV-mf global e central podem ser utilizados na detecção de anormalidades do campo visual em pacientes portadores de compressão quiasmática / PURPOSE: To evaluate the ability of multifocal visual evoked potential (mfVEP) to differentiate patients with temporal hemianopia due to chiasmal compression from normal controls. To assess the relationship between mfVEP, standard automated perimetry (SAP) and fourier domain-optical coherence tomography (fd-OCT). METHODS: Twenty-seven eyes of 21 patients with permanent temporal visual field (VF) defects from chiasmal compression and 43 eyes of 23 healthy controls underwent mfVEP, SAP and fd-OCT (3D OCT-1000®, Topcon) macular and peripapillary retinal nerve fiber layer (RNFL) measurements. It was averaged the responses for global mfVEP, central mfVEP and fd-OCT macular measurements were averaged in quadrants and halves, while peripapillary RNFL thickness was averaged in 12 sectors around the disc. VF loss was estimated in four quadrants and each half of 24-2 and 10-2 strategy test points. The two groups were compared using generalized estimated equations (GEE). Correlations between mfVEP, VF and fd-OCT findings were verified. RESULTS: Global and central mfVEP P1 and N2 amplitude parameters of temporal measurements were significantly smaller in patients than controls (p < 0.004). No significant differences were observed between the groups with respect to mfVEP amplitude parameters from the nasal measurements. No significant differences were observed in global and central mfVEP latency parameters for all averaged measurements between patients and healthy controls. A significant moderate correlation was found between global and central mfVEP amplitude parameters of temporal measurements and temporal VF 24-2 and 10-2 loss as well as with corresponding fd-OCT macular and RNFL thickness measurements. CONCLUSIONS: mfVEP amplitude parameters were able to differentiate eyes with temporal hemianopia from controls and were significant correlated with VF and fd-OCT findings. These data suggest that it is a useful technology for detecting visual abnormalities in patients with chiasmal compression

OBJETIVO: Investigar a correlação entre as espessuras da mácula e da camada de fibras nervosas da retina (CFNR), medidas pelas tomografias de coerência óptica de domínio Fourier (FD - OCT) e de domínio do tempo (TD - OCT) e a perda de sensibilidade no campo visual (CV) em pacientes com atrofia em banda do nervo óptico. Comparar a habilidade diagnóstica dos dois instrumentos. MÉTODOS: 36 olhos de 36 pacientes com perda de CV permanente por compressão do quiasma óptico e 36 controles normais foram submetidos ao exame de CV pela perimetria automatizada padrão (Humphrey Field Analyzer TM; Carl Zeiss Meditec, Dublin, CA), ao FD - OCT (3 D OCT-1000TM Topcon Corp., Tokyo, Japan) e ao TD - OCT (StratusTM ;Carl Zeiss Meditec Inc, Dublin, California, USA). Foram comparados os protocolos análogos de ambos os equipamentos para avaliação da espessura macular.Foi realizado a divisão macular em quatro quadrantes e em metades, sendo calculado a média da espessura macular global, a média da espessura dos quadrantes e a média da espessura das metades maculares. A média global e setorial da medida da espessura da CFNR peripapilar também foi analisada. A perda de sensibilidade no CV foi inicialmente avaliada pelo defeito temporal médio. O CV foi ainda dividido em 6 setores de acordo com a distribuição da CFNR e em 16 pontos centrais para a realização da correlação estrutura-função entre os parâmetros medidos pelo FD - OCT e a perda de sensibilidade no CV em decibéis e 1/Lambert. Foi calculado o coeficiente de correlação de Sperman e a análise de regressão linear. As áreas sobre a curva ROC e valores fixos de sensibilidade e especificidade foram calculados para cada parâmetro estudado. RESULTADOS: As medidas da espessura macular e da CFNR pelo FD - OCT e TD - OCT foram capazes de discriminar olhos com atrofia em banda do nervo óptico dos controles normais. A espessura global e setorial dos parâmetros maculares e da CFNR mostraram diferenças significativas (p<0,001) entre os doentes e os controles e os dois aparelhos tiveram desempenho semelhante na discriminação entre pacientes e controles. Em ambos existiram correlações significativas entre a perda de sensibilidade do CV e as medidas da espessura macular e da CFNR. As medidas de espessura nos quadrantes e nas metades nasais da macula, avaliadas pelo FD - OCT tiveram os melhores desempenhos nas correlações com os defeitos de CV, sendo o parâmetro com a melhor correlação, a medida do quadrante infero-nasal da mácula e a perda de sensibilidade do CV central do quadrante temporal superior central (r = 0.78, R2 = 61%, p<0,001). CONCLUSÕES: A espessura macular e a espessura da CFNR medidas pelo FD - OCT e pelo TD - OCT se correlacionaram topograficamente com a perda de sensibilidade no CV de pacientes com hemianopsia temporal por compressäo quiasmática. A correlação entre os quadrantes maculares e a perda de sensibilidade no CV, foram melhores do que aquelas entre o CV e as medidas da CFNR, principalmente nas medidas realizadas pelo FD - OCT. Este estudo demonstrou a importância clínica das medidas maculares na correlação estrutura-função e na quantificaçäo do dano neural em pacientes com compressão quiasmática, podendo ser útil na monitorização destes pacientes / PURPOSE: To investigate the relationship between fourier-domain optical coherence tomography (FD - OCT) measured macular and retinal nerve fiber layer thickness (RNFL) and visual field sensitivity loss on standard automated perimetry in eyes with permanent temporal hemianopia from chiasmal compression and compare the ability of FD - OCT and time-domain optical coherence tomography (TD - OCT) to detect axonal loss in eyes with band atrophy of the optic nerve. METHODS: One eye of each of 36 patients with permanent temporal visual field defects and 36 age- and sex-matched healthy subjects. Subjects underwent standard automated perimetry and macular and RNFL thickness measurements with FD - OCT (3 D OCT-1000® Topcon Corp., Tokyo, Japan) and TD - OCT (Stratus; Carl Zeiss Meditec Inc, Dublin, California, USA). Macular thickness measurements as a global average, divided in four quadrants and in two halves as well as average and sectoral RNFL thickness around the optic disc were calculated. Visual field sensitivity loss was evaluated by the temporal mean defect; as deviations from normal in six sectors of the visual field and in 16 central visual field test points. Relationship between visual field sensitivity loss in decibel and 1/Lambert units and optical coherence tomography measurements were evaluated using Spearman correlation coefficients and by linear regression analysis. Receiver operating characteristic curves and sensitivities at fixed specificities were calculated for each parameter. RESULTS: Global and sectoral macular and RNFL thickness parameters showed a significant difference in eyes with band atrophy compared with controls. The strongest correlations were seen between visual field sensitivity loss and quadrantic or hemianopic nasal macular thickness measurements than with sectoral retinal nerve fiber layer thickness measurements. The highest correlation was observed between the inferonasal quadrant macular thickness and the visual field sensitivity loss in the superior temporal central visual field quadrant (r = 0.78, R2 = 61%, p <0.001). CONCLUSION: Both RNFL thickness and macular thickness FD - OCT and TD - OCT measurements were related topographically with visual field sensitivity loss in patients with temporal hemianopia from chiasmal compression and there is a stronger relationship in quadrantic macular compared to RNFL thickness measurements with FD - OCT. Macular thickness measurements could potentially be used to quantify neuronal loss in patients with chiasmal compression and could prove clinically useful for detection of damage and for monitoring these patients