Advances in transsynaptic retrograde degeneration of optic neuropathy / 中华眼底病杂志

Transsynaptic retrograde degeneration of optic neuropathy (TRDON) refers to the degeneration and/or apoptosis of presynaptic neurons (retinal ganglion cells) caused by damage to the lateral geniculate body and post-geniculate visual pathway. At present, the pathogenesis of TRDON is secondary apoptosis of P β-type retinal ganglion cells, resulting in the atrophy of optic tract, thinning of the retinal nerve fiber layer and retinal ganglion cell layer thickness and declining of retinal microvascular density, which are consistent with the visual field defect attributed to the primary disease. Of which, the thinning of the retinal ganglion cell layer thickness is considered as the characteristic of TRDON. Now, there is little understanding and related research on TRDON in China. Clinicians should pay attention to the characteristics and severity, occurrence time and location of the above structural changes in these patients through optical coherence tomography, and monitor the activity and progress of the lesions, so as to determine the cut-off point for drug intervention and the drug targets for developing new treatment methods, and bring benefits for patients in partial visual function recovery and disability reduction.

Ganglion Cell Analysis in an Optic Tract Syndrome Patient Previously Diagnosed with Glaucoma

PURPOSE: To report the results of ganglion cell analysis in a patient with optic tract syndrome who was previously diagnosed with glaucoma. CASE SUMMARY: A 32-year-old male, who had been diagnosed with glaucoma 12 years ago, but had not visited an ophthalmology clinic since then, came to our clinic for evaluation of his glaucoma. Both eyes showed an increased cup-to-disc ratio and temporal pallor of the disc. Retinal nerve fiber layer (RNFL) optical coherence tomography showed thinning of the superior, inferior, and temporal peripapillary RNFL in both eyes. On ganglion cell analysis (GCA), ganglion cell layer thinning in the nasal region of the right eye and in the temporal region of the left eye was observed. The visual field test showed right incongruous homonymous hemianopsia. After the atrophic change of the left optic tract was confirmed by orbit magnetic resonance imaging, he was diagnosed with left optic tract syndrome. CONCLUSIONS: We report the results of GCA in a case of optic tract syndrome, previously diagnosed as glaucoma. GCA can be useful when diagnosing optic tract syndrome.

Pediatric Glioma at the Optic Pathway and Thalamus

Gliomas are the most common pediatric tumors of the central nervous system. In this review, we discuss the clinical features, treatment paradigms, and evolving concepts related to two types of pediatric gliomas affecting two main locations: the optic pathway and thalamus. In particular, we discuss recently revised pathologic classification, which adopting molecular parameter. We believe that our review contribute to the readers' better understanding of pediatric glioma because pediatric glioma differs in many ways from adult glioma according to the newest advances in molecular characterization of this tumor. A better understanding of current and evolving issues in pediatric glioma is needed to ensure effective management decision.

Pediatric Glioma at the Optic Pathway and Thalamus

Gliomas are the most common pediatric tumors of the central nervous system. In this review, we discuss the clinical features, treatment paradigms, and evolving concepts related to two types of pediatric gliomas affecting two main locations: the optic pathway and thalamus. In particular, we discuss recently revised pathologic classification, which adopting molecular parameter. We believe that our review contribute to the readers' better understanding of pediatric glioma because pediatric glioma differs in many ways from adult glioma according to the newest advances in molecular characterization of this tumor. A better understanding of current and evolving issues in pediatric glioma is needed to ensure effective management decision.

Prenatal ultrasonic research of fetal optic chiasma / 中华超声影像学杂志

Objective To research fetal optic nerve,optic chiasma and optic tract size using high resolution prenatal ultrasound,establish a scan method and the reference range of optic nerve,optic chiasma and optic tract in normal fetus.Methods Based on the section of circulus arteriosus cerebri,the probe were rotated to get the chiasma section for measuring the diameter of bilateral optic nerve,optic tract and area of optic chiasma in 453 normal fetus respectively.Used gestation age and corresponding biological parameters as independent variables,the regression equation was established analyse the gender differences.Results 26-33 weeks was the preferable gestational age to visualize the chiasma section.It had good repeatability except chiasma area.The bilateral optic nerve and optic tract diameter,optic chiasma diameter and area had an increased along with the gestational age reposefully.There was no significant difference between the two sides of optic nerve and the gender.Conclusions Prenatal ultrasound can assess the size and shape of fetal optic nerve,optic chiasma and optic tract.The normal reference range,established by ultrasound,is helpful to diagnose the abnormality of optic chiasma.

Analysis of Visual Field Defect in Patient with Brain Lesion

PURPOSE: In this study we analyzed the results of visual field tests in patients diagnosed with a brain lesion in an ophthalmology clinic. METHODS: The medical records of 55 patients who underwent visual field examinations and diagnosed with brain pathology using magnetic resonance imaging (MRI) from January 1, 2005 to June 30, 2014 were retrospectively investigated. RESULTS: Of the 55 patients (M:F = 30:25), 31 displayed symmetrical hemianopsia, a typical visual field defect associated with brain lesions. Twenty-four patients showed atypical visual field defect (20 showed normal visual field despite the brain lesion, 3 had bilateral narrowing of the peripheral visual field in 2 cerebral infarctions and 1 multiple sclerosis, and 1 had horizontal inferior visual field defect in 1 eye from nasopharyngeal cancer). CONCLUSIONS: Patients having a brain lesion with the optic tract invasion may present with atypical visual field defects. The peripheral visual field constriction and horizontal inferior visual field defect in 1 eye could be the visual field defect in patients with a brain lesion.

The Optical Coherence Tomography Findings of Optic Tract Syndrome

PURPOSE: To report a case of optic tract syndrome in which optical coherence tomography (OCT) demonstrated the specific findings of the retinal nerve fiber layer (RNFL). CASE SUMMARY: A 32-year-old male patient visited the hospital with right side visual field defect in both eyes that occurred immediately after a traffic accident 8 months prior. The visual acuity of both eyes was normal, and a relative afferent papillary defect was evident in the right eye. In addition, suspicious band atrophy of the right optic disc and thinning of the superior and inferior arcuate bundle were observed in the left eye. On visual field examination, homonymous hemianopia was present. Optic tract syndrome was suspected, although there was no abnormality of the visual tract on MRI. On fast RNFL thickness 3.4 scan, a thinning of RNFL in the nasal and temporal segments in the right eye and superior and inferior segments in the left eye were observed. Based on the findings, optic tract syndrome was diagnosed in the left eye. CONCLUSIONS: We report specific OCT findings which can be useful when making a diagnosis of optic tract syndrome.

Avaliação da camada de fibras nervosas da retina nas afecções neuroftalmológicas da via óptica anterior / Retinal nerve fiber evaluation in neuro-ophthalmic diseases of the anterior visual pathway

A avaliação da camada de fibras nervosas da retina tem grande importância no diagnóstico e acompanhamento de várias afecções da via óptica anterior. Nesta revisão, discutiremos os principais métodos de análise clínica e instrumental da camada de fibras nervosas da retina e revisamos os principais achados encontrados nas afecções da via óptica anterior incluindo lesões inflamatórias, isquêmicas, tóxicas, hereditárias, compressivas e traumáticas do nervo óptico, as lesões do quiasma óptico, as do trato óptico e aquelas do corpo geniculado lateral.

Retinal nerve fiber evaluation is important in the diagnosis and management of several diseases of the anterior visual pathway. In this report we review the clinical findings and the current techonologies avalilable to analyse the retinal nerve fiber layer. We furthermore review the main findings in several disease of the anterior visual pathways including inflammatory, ischemic, toxics, hereditary, compressive and traumatic optic neuropathies as well as lesion of the optic chiasm, optic tract and lateral geniculate body.