Visual signs and symptoms in patients with the visual variant of Alzheimer disease.

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Version: Final published version
Serval ID
serval:BIB_C6E015079AD8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Visual signs and symptoms in patients with the visual variant of Alzheimer disease.
Journal
Bmc Ophthalmology
Author(s)
Kaeser P.F., Ghika J., Borruat F.X.
ISSN
1471-2415 (Electronic)
ISSN-L
1471-2415
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
15
Number
1
Pages
65
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
BACKGROUND: Prominent visual symptoms can present in the visual variant of Alzheimer's disease (VVAD). Ophthalmologists have a significant role to play in the early diagnosis of VVAD.
METHODS: We retrospectively reviewed the files of ten consecutive patients diagnosed with VVAD. All patients had a full neuro-ophthalmologic examination, a formal neurological and neuro-psychological testing, and cerebral MRI to confirm diagnosis. In addition, functional neuroimaging was obtained in seven patients.
RESULTS: The common primary symptom at presentation with all patients was difficulty with near vision (reading difficulty n = 8, "visual blur" in near vision n = 2), and difficulty writing (n = 3). Following assessment, impaired reading and writing skills were evident in 9/10 and 8/10 patients respectively. Median distance visual acuity was 20/25 and at near the median visual acuity was J6. Partial homonymous visual field defect was detected in 80 % (8/10) of the patients. Color vision was impaired in all patients when tested with Ishihara pseudoisochromatic plates, but simple color naming was normal in 8/9 tested patients. Simultanagnosia was present in 8/10 patients. Vision dysfunction corresponded with cerebral MRI findings where parieto-occipital cortical atrophy was observed in all patients. PET scan (5 patients) or SPECT (2 patients) revealed parieto-occipital dysfunction (hypometabolism or hypoperfusion) in all 7 tested patients
CONCLUSIONS: Visual difficulties are prominent in VVAD. Dyslexia, incomplete homonymous hemianopia, preserved color identification with abnormal color vision on Ishihara, and simultanagnosia were all symptoms observed frequently in this patient series. Ophthalmologists should be aware of the possibility of neurodegenerative disorders such as VVAD in patients with unexplained visual complaints, in particular reading difficulties.
Pubmed
Web of science
Open Access
Yes
Create date
06/07/2015 9:13
Last modification date
20/08/2019 15:42
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