Follow-up of visual field defects with vascular damage of the geniculostriate visual pathway

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Abstract
Spontaneous regression of visual field defects in 25 hemianopias, nine quadrant-anopias and three cases of cortical blindness was followed-up over 36 months. The localization of the lesions (31 infarcts, six hematomas) was related to the degree of recovery. The processes of functional restoration were largely completed after six months. On average, the increase in the visual field after three years was 6.5% in quadrantanopia, 15.7% in hemianopia, and 36.7% in cortical blindness. The visual field recovered completely only in one case, and not at all in five cases. Whereas the best recovery could be observed in lesions of the occipital pole, those in the striate area had the poorest prognosis. The cause of the lesion (infarct, hemorrhage) did not have any effect on functional restoration. The return of visual performance frequently occurred in the form of finger-like extensions in the periphery of the ipsilateral (quadrantanopia) or the adjacent contralateral (hemianopia) quadrants, which is explained by the effect of the magnification factor.