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Scotoma

MedGen UID:
19902
Concept ID:
C0036454
Finding; Finding
Synonym: Scotoma (disease)
SNOMED CT: Visual field scotoma (23388006)
 
HPO: HP:0000575
Monarch Initiative: MONDO:0004758

Definition

A regional and pathological increase of the light detection threshold in any region of the visual field surrounded by a field of normal or relatively well-preserved vision. [from HPO]

Conditions with this feature

Retinitis pigmentosa 1
MedGen UID:
67395
Concept ID:
C0220701
Disease or Syndrome
Any retinitis pigmentosa in which the cause of the disease is a mutation in the RP1 gene.
Retinitis pigmentosa 18
MedGen UID:
371314
Concept ID:
C1832378
Disease or Syndrome
Any retinitis pigmentosa in which the cause of the disease is a mutation in the PRPF3 gene.
Optic atrophy 3
MedGen UID:
371657
Concept ID:
C1833809
Disease or Syndrome
Autosomal dominant optic atrophy and cataract is an eye disorder that is characterized by impaired vision. Most affected individuals have decreased sharpness of vision (visual acuity) from birth, while others begin to experience vision problems in early childhood or later. In affected individuals, both eyes are usually affected equally. However, the severity of the vision loss varies widely, even among affected members of the same family, ranging from nearly normal vision to complete blindness.\n\nSeveral abnormalities contribute to impaired vision in people with autosomal dominant optic atrophy and cataract. In the early stages of the condition, affected individuals experience a progressive loss of certain cells within the retina, which is a specialized light-sensitive tissue that lines the back of the eye. The loss of these cells (known as retinal ganglion cells) is followed by the degeneration (atrophy) of the nerves that relay visual information from the eyes to the brain (optic nerves), which contributes to vision loss. Atrophy of these nerves causes an abnormally pale appearance (pallor) of the optic nerves, which can be seen only during an eye examination. Most people with this disorder also have clouding of the lenses of the eyes (cataracts). This eye abnormality can develop anytime but typically appears in childhood. Other common eye problems in autosomal dominant optic atrophy and cataract include involuntary movements of the eyes (nystagmus), or problems with color vision (color vision deficiency) that make it difficult or impossible to distinguish between shades of blue and green.\n\nSome people with autosomal dominant optic atrophy and cataract develop disturbances in the function of other nerves (neuropathy) besides the optic nerves. These disturbances can lead to problems with balance and coordination (cerebellar ataxia), an unsteady style of walking (gait), prickling or tingling sensations (paresthesias) in the arms and legs, progressive muscle stiffness (spasticity), or rhythmic shaking (tremors). In some cases, affected individuals have hearing loss caused by abnormalities of the inner ear (sensorineural deafness).
Cone dystrophy with supernormal rod response
MedGen UID:
332081
Concept ID:
C1835897
Disease or Syndrome
Cone dystrophy with supernormal rod responses (CDSRR) is characterized by onset in the first or second decade of life of very marked photophobia, myopia, reduced color vision along the red-green axis with relatively preserved tritan discrimination, and central scotomata with peripheral widespread sensitivity loss predominating in the superior visual field. Nyctalopia is a later feature of the disorder. There is often retinal pigment epithelium disturbance at the macula with a normal retinal periphery. Autofluorescence (AF) imaging shows either a perifoveal ring or a central macular area of relative increased AF (summary by Michaelides et al., 2005).
Newfoundland cone-rod dystrophy
MedGen UID:
334840
Concept ID:
C1843815
Disease or Syndrome
Newfoundland rod-cone dystrophy (NFRCD) is a severe retinal dystrophy in which night blindness is present from infancy. Progressive loss of peripheral, central, and color vision begins in childhood and results in severe visual loss by the second to fourth decade of life (Eichers et al., 2002).
Late-onset retinal degeneration
MedGen UID:
344198
Concept ID:
C1854065
Disease or Syndrome
Late-onset retinal degeneration (LORD) is an autosomal dominant disorder characterized by onset in the fifth to sixth decade with night blindness and punctate yellow-white deposits in the retinal fundus, progressing to severe central and peripheral degeneration, with choroidal neovascularization and chorioretinal atrophy (Hayward et al., 2003).
Jalili syndrome
MedGen UID:
501210
Concept ID:
C3495589
Disease or Syndrome
Jalili syndrome is an autosomal recessive disorder consisting of cone-rod dystrophy and amelogenesis imperfecta. Significant visual impairment with nystagmus and photophobia is present from infancy or early childhood and progresses with age. Enamel of primary and secondary dentitions is grossly abnormal and prone to rapid posteruptive failure, in part reflecting hypomineralization (summary by Parry et al., 2009).
Neuropathy, hereditary motor and sensory, type 6B
MedGen UID:
895482
Concept ID:
C4225302
Disease or Syndrome
Hereditary motor and sensory neuropathy type VIB is an autosomal recessive complex progressive neurologic disorder characterized mainly by early-onset optic atrophy resulting in progressive visual loss and peripheral axonal sensorimotor neuropathy with highly variable age at onset and severity. Affected individuals may also have cerebellar or pontocerebellar atrophy on brain imaging, and they may show abnormal movements such as ataxia, dysmetria, and myoclonus (summary by Abrams et al., 2015). For a general phenotypic description and a discussion of genetic heterogeneity of HMSN6, see HMSN6A (601152).
Cone-rod dystrophy 24
MedGen UID:
1841082
Concept ID:
C5830446
Disease or Syndrome
Cone-rod dystrophy-24 (CORD24) is characterized by night blindness, defective color vision, and reduced visual acuity. Macular atrophy, macular pigmentation deposits, and drusen-like deposits in the macula have been observed. Age at onset varies widely, from the first to the sixth decades of live (Kobayashi et al., 2000; Huang et al., 2013; Zenteno et al., 2023). For a general phenotypic description and discussion of genetic heterogeneity of CORD, see CORD2 (120970).

Professional guidelines

PubMed

Özmert E, Arslan U
Adv Ther 2019 Sep;36(9):2273-2286. Epub 2019 Aug 5 doi: 10.1007/s12325-019-01040-2. PMID: 31385285
Shulman M, Sepah YJ, Chang S, Abrams GW, Do DV, Nguyen QD
Ophthalmic Surg Lasers Imaging Retina 2013 Nov 1;44(6):577-83. doi: 10.3928/23258160-20131105-07. PMID: 24221464
Schäfer HH, De Villiers JN, Sudano I, Dischinger S, Theus GR, Zilla P, Dieterle T
Swiss Med Wkly 2012;142:w13574. Epub 2012 May 9 doi: 10.4414/smw.2012.13574. PMID: 22573500

Recent clinical studies

Etiology

Mbu-Nyamsi D, Vincent M, Perez-Fontana M, Best AL, Mesnard C, Villeroy F, Foucher A, Raffray L, Terrier CS, Bertolotti A
BMC Infect Dis 2023 Aug 2;23(1):506. doi: 10.1186/s12879-023-08432-4. PMID: 37528344Free PMC Article
Josan AS, Farrance I, Taylor LJ, Adeyoju D, Buckley TMW, Jolly JK, MacLaren RE
Transl Vis Sci Technol 2023 May 1;12(5):21. doi: 10.1167/tvst.12.5.21. PMID: 37219509Free PMC Article
Viana M, Tronvik EA, Do TP, Zecca C, Hougaard A
J Headache Pain 2019 May 30;20(1):64. doi: 10.1186/s10194-019-1008-x. PMID: 31146673Free PMC Article
Tsang SH, Sharma T
Adv Exp Med Biol 2018;1085:223-226. doi: 10.1007/978-3-319-95046-4_47. PMID: 30578520
Krill AE, Deutman AF, Fishman M
Doc Ophthalmol 1973 Apr 16;35(1):1-80. doi: 10.1007/BF00234530. PMID: 4573331

Diagnosis

Ghoshhajra B
J Cardiovasc Comput Tomogr 2023 May-Jun;17(3):165. doi: 10.1016/j.jcct.2023.05.236. PMID: 37277165
Josan AS, Farrance I, Taylor LJ, Adeyoju D, Buckley TMW, Jolly JK, MacLaren RE
Transl Vis Sci Technol 2023 May 1;12(5):21. doi: 10.1167/tvst.12.5.21. PMID: 37219509Free PMC Article
D'Souza HS, Tailor PD, Olsen TW
JAMA Ophthalmol 2023 Jan 1;141(1):97-98. doi: 10.1001/jamaophthalmol.2022.5235. PMID: 36480182
Virdee J, Mollan SP
Pract Neurol 2020 Oct;20(5):415-419. Epub 2020 Jun 14 doi: 10.1136/practneurol-2019-002460. PMID: 32536606
Marvasti AH, Chen KC, Ferreyra HA, Falardeau J
Surv Ophthalmol 2019 Jan-Feb;64(1):117-122. Epub 2017 Jul 4 doi: 10.1016/j.survophthal.2017.06.006. PMID: 28684101

Therapy

Mansoori T
Indian J Ophthalmol 2022 Dec;70(12):4471. doi: 10.4103/ijo.IJO_1310_22. PMID: 36453381Free PMC Article
Jiang Y, Zhu Z, Tan X, Kong X, Zhong H, Zhang J, Xiong R, Yuan Y, Zeng J, Morgan IG, He M
Ophthalmology 2022 May;129(5):509-519. Epub 2021 Dec 1 doi: 10.1016/j.ophtha.2021.11.023. PMID: 34863776
Proano C, Kimball GP
N Engl J Med 2019 Apr 25;380(17):e27. doi: 10.1056/NEJMicm1304542. PMID: 31018072
Yuan L, Prayson RA
J Clin Neurosci 2015 Jul;22(7):1191-3. Epub 2015 Apr 7 doi: 10.1016/j.jocn.2015.01.012. PMID: 25861888
Lang GE, Kuba GB
Am J Ophthalmol 1997 Mar;123(3):418-20. doi: 10.1016/s0002-9394(14)70149-7. PMID: 9063263

Prognosis

Ghoshhajra B
J Cardiovasc Comput Tomogr 2023 May-Jun;17(3):165. doi: 10.1016/j.jcct.2023.05.236. PMID: 37277165
Cohen SY, Mrejen S, Nghiem-Buffet S, Dubois L, Fajnkuchen F, Gaudric A
Ophthalmol Retina 2021 Jun;5(6):553-561. Epub 2020 Sep 30 doi: 10.1016/j.oret.2020.09.018. PMID: 33007522
Abdelhakim A, Rasool N
Curr Opin Ophthalmol 2018 Nov;29(6):514-519. doi: 10.1097/ICU.0000000000000527. PMID: 30148725
Yuan L, Prayson RA
J Clin Neurosci 2015 Jul;22(7):1191-3. Epub 2015 Apr 7 doi: 10.1016/j.jocn.2015.01.012. PMID: 25861888
Krill AE, Deutman AF, Fishman M
Doc Ophthalmol 1973 Apr 16;35(1):1-80. doi: 10.1007/BF00234530. PMID: 4573331

Clinical prediction guides

Mbu-Nyamsi D, Vincent M, Perez-Fontana M, Best AL, Mesnard C, Villeroy F, Foucher A, Raffray L, Terrier CS, Bertolotti A
BMC Infect Dis 2023 Aug 2;23(1):506. doi: 10.1186/s12879-023-08432-4. PMID: 37528344Free PMC Article
Ghoshhajra B
J Cardiovasc Comput Tomogr 2023 May-Jun;17(3):165. doi: 10.1016/j.jcct.2023.05.236. PMID: 37277165
Verghese P, Ghahghaei S, Lively Z
J Vis 2022 Dec 1;22(13):7. doi: 10.1167/jov.22.13.7. PMID: 36580297Free PMC Article
Seizova-Cajic T, Adamian N, Duyck M, Cavanagh P
Perception 2019 Feb;48(2):115-137. doi: 10.1177/0301006619825769. PMID: 30799731
Markowitz SN, Reyes SV
Can J Ophthalmol 2013 Oct;48(5):350-7. Epub 2012 Oct 23 doi: 10.1016/j.jcjo.2012.03.004. PMID: 24093179

Recent systematic reviews

Abu Serhan H, Abu Suilik H, Hassan AK, AlSamhori JF, Hassan AR, Siddiq A, Ahmed N, Elnahry AG
Int Ophthalmol 2024 Apr 23;44(1):189. doi: 10.1007/s10792-024-03119-4. PMID: 38652153Free PMC Article
Matías-Pérez D, García-Montalvo IA
J Oleo Sci 2021 Apr 2;70(4):453-458. Epub 2021 Mar 10 doi: 10.5650/jos.ess20314. PMID: 33692241
Viana M, Tronvik EA, Do TP, Zecca C, Hougaard A
J Headache Pain 2019 May 30;20(1):64. doi: 10.1186/s10194-019-1008-x. PMID: 31146673Free PMC Article
Gaffney AJ, Margrain TH, Bunce CV, Binns AM
Ophthalmic Physiol Opt 2014 Jul;34(4):427-37. Epub 2014 Apr 15 doi: 10.1111/opo.12132. PMID: 24735182
Virgili G, Bini A
Cochrane Database Syst Rev 2007 Jul 18;(3):CD004763. doi: 10.1002/14651858.CD004763.pub2. PMID: 17636773

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