Visual field defects in neuropsychiatric disorders

Abstract

Unusual evanescent modest visual field anomalies have previously been defined in patients with Tourette syndrome and their blood relatives. These anomalies include nasal and temporal steps, occasional enlarged blind spots, baring of the blind spot, and a curious partial or complete 'ringing' of the blind spot by a narrow isopter. Additionally, some individuals show two different time-based losses in sensitivity.

In order to determine whether this unique set of visual field anomalies is limited to Tourette syndrome, an extended masked study is being conducted in cooperation with the Psychiatric Service at Children's Hospital, Oakland, CA. A number of categories of clearly defined neuropsychiatric disorders and normals are being studied. Parents, proband children, and siblings are being examined.

Nearly identical visual field anomalies have now been found in at least two more groups of patients. They are obsessive-compulsive disorder and bipolar (manic-depressive) disorder. The frequency of visual field anomalies is extremely high in the proband children and many of the family members. Data in other neuropsychiatric categories, such as unipolar depressions, schizophrenia, autism, and panic disorder, are too limited at this time to draw conclusions.

This extensive test program is in mid-phase, but certain findings are evident based on ongoing analyses. The code, however, has not yet been broken.

Key Words:

• Visual fields
• neuropsychiatric disorders
• Tourette syndrome
• obsessive-compulsive disorder
• bipolar disorder (manic-depressive disorder)
• time-varying changes in visual fields