(眼科学课件）12-视神经病变.pptx

Neuro-ophthalmology眼耳鼻喉科医院 江睿2014-06-09 09:55-11:35神经眼科学荷露斯-古埃及最重要的神之一是太阳神Osiris与保护女神Isis的孩子通常被描述为戴着埃及皇冠的神鹰古埃及的法老们都视自己为荷露斯的化身鹰头人身的天神荷露斯（Horus）Visual Pathwayoptic tractoptic radiationoptic chiasmPage77Optic cortexThe optic nerveIntraocular portion1 million axons—RGC--nerve fiber layerThe orbital segment 25–30 mm longBecome myelinated increasing the diameter from ?1.5 mm -3 mm The intracanalicular portion measures 4–9 mm. the bony optic canalIntracranial course 10 mmjoins the opposite optic nerveform the optic chiasmSchematic representation of the course of ganglion cell axons in the retinaWinged Victory of Samothrace (Nike of Samothrake)Relative afferent pupillary defect (RAPD)Visual field defects in optic nerve diseasea. central scotoma b. centrocaecal scotomac. nerve fibre bundle d. altitudinalTypes of visual fields defects and lesions of visual pathwayVisual Evoked Potential(VEP)Congenital abnormalities of optic nerveOptic disc hypoplasiaCongenital optic pitsTilted optic discMorning glory optic disc anomaly Medullated retinal nerveHypoplastic optic discouter ring - the junction of the sclera and lamina cribrosa,inner ring - the termination of the retina and retinal pigment epithelium, both abnormally extend centrally over the lamina cribrosaCongenital pit of the optic nerve headA. Gray and inferotemporally located pit Mild peripapillary chorioretinal changes. B. Secondary macular retinal detachmentTilted optic discMorning glory optic disc anomalyThe retinal vessels enter and leave the nerve head at its marginsassociated rhegmatogenous retinal detachmentMedullated nerve fiberINFLAMMATORY OPTIC NEUROPATHIES: OPTIC NEURITISThe medical rubric “optic neuritis” is perhaps more a clinical syndrome than a topical diseaseBy the suffix “-itis” is understood inflammation of the nervebut this modest definition fails to convey the complex nosologic spectrum that embraces the following conditions:demyelinative, other immune-mediated, infective, and idiopathic optic neuritide