Poorer visual outcomes after stroke associated with age

In patients with stroke, elderly had poor slow binocular and slow and fast monocular vergence. These results of a prospective study were published in the Journal of Neuro-Ophthalmology.

Patients (n = 305, 102 females, mean age 61.4 ± 13.8 years) with stroke referred to the University of Athens in Greece for cerebrovascular evaluation and treatment underwent a bedside convergence assessment. The assessment included 6 steps that assessed slow or fast, symmetric or asymmetric, binocular or monocular vergence. A group of control participants of the same age (n = 50, 19 women, 68.1 ± 11.1 years) served as comparison group. Patients had an ischemic (n=283) or hemorrhagic (n=22) stroke with a Fazekas score of 0 to 1 (n=241) or 2 to 3 (n=64).

Patients had deficits in slow (χ2, 65.8; P<.001) and fast (χ2, 34.3; P<.001) binocular vergence, as well as slow (χ2, 14.1; P<.01) and fast (χ2, 30.8; P<.001) monocular vergence of the right eye and slow (χ2, 13.4; P<.01) and fast (χ2, 16.4; P<.001) monocular vergence of the left eyes.

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Age was associated with slow binocular vergence and slow and fast monocular vergence of the right and left eyes (all P ≤ 0.01); Parietal lobe frontal beat with slow and fast monocular vergence of right and left eyes (all P ≤.01); and controls with slow binocular vergence and fast monocular vergence of the right eye (both P ≤ 0.05).

The side of the lesion had no effect on vergence parameters, except that right-sided lesions were associated with poorer performance (χ2, 13.4; p<0.01). Patients with right occipital lesion and left homonymous hemianopsia had right eye defective rapid vergence (χ2, 13.4; P<.01) and left occipital lesions and right homonymous hemianopsia with left eye rapid vergence (χ2, 10.6; P<.01). P<.01).

In patients with magnetic resonance imaging data, patients with Fazekas scores of 2–3 had decreased fast binocular vergence (χ2, 15.4; p<0.05) and slow (χ2, 6.6; p<0.05) and fast (χ2, 7.0; p<0.05). P<.05) Left eye vergence.

This study was biased toward hemispheric stroke and may be underpowered for subcortical infarcts.

These data indicate that there was limited localization value of deficits in patients who had stroke. Parietal lobe infarcts were more frequently associated with binocular and monocular vergence.


Anagnostou E, Koutsoudaki P, Tountopoulou A, Spengos K, Vassilopoulou S. Assessment of bedside vergence in stroke patients. J Neuroophthalmol. 2021;41(4):424-430. doi:10.1097/WNO.0000000000001035

This article originally appeared on Ophthalmology Advisor

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