Objective Assessment of Visual Field Defects Caused by Optic Chiasm and Its Posterior Visual Pathway Injury / 法医学杂志

OBJECTIVES@#To investigate the characteristics and objective assessment method of visual field defects caused by optic chiasm and its posterior visual pathway injury.@*METHODS@#Typical cases of visual field defects caused by injuries to the optic chiasm, optic tracts, optic radiations, and visual cortex were selected. Visual field examinations, visual evoked potential (VEP) and multifocal visual evolved potential (mfVEP) measurements, craniocerebral CT/MRI, and retinal optical coherence tomography (OCT) were performed, respectively, and the aforementioned visual electrophysiological and neuroimaging indicators were analyzed comprehensively.@*RESULTS@#The electrophysiological manifestations of visual field defects caused by optic chiasm injuries were bitemporal hemianopsia mfVEP abnormalities. The visual field defects caused by optic tract, optic radiation, and visual cortex injuries were all manifested homonymous hemianopsia mfVEP abnormalities contralateral to the lesion. Mild relative afferent pupil disorder (RAPD) and characteristic optic nerve atrophy were observed in hemianopsia patients with optic tract injuries, but not in patients with optic radiation or visual cortex injuries. Neuroimaging could provide morphological evidence of damages to the optic chiasm and its posterior visual pathway.@*CONCLUSIONS@#Visual field defects caused by optic chiasm, optic tract, optic radiation, and visual cortex injuries have their respective characteristics. The combined application of mfVEP and static visual field measurements, in combination with neuroimaging, can maximize the assessment of the location and degree of visual pathway damage, providing an effective scheme for the identification of such injuries.

Amaurose por neuropatia óptica traumática direta secundária à corpo estranho transorbitário: relato de um caso atípico / Amaurosis by Traumatic Optic Neuropathy direct secondary to the "transorbitario" foreign body: Report of an atypical case

Resumo Neste trabalho descreve-se o caso clínico de um paciente do sexo masculino que evoluiu para cegueira tardia por neuropatia óptica traumática após queda de bicicleta. Enfatiza-se a importância do exame oftalmológico/reflexos pupilares e da tomografia computadorizada no diagnóstico de corpo estranho orbitário, sua remoção cirúrgica, abordagem interdisciplinar e evolução.

Abstract The purpose of this research is to describe a clinical study of a male patient who experienced late-blindness due to traumatic optic neuropathy after getting into a bicycle accident. It is stressed the importance of performing pupillary/reflexes examination and computed tomography scan in order to diagnose "transorbitário" foreign body. It is also cover its surgical removal as well as an interdisciplinary approach and clinical evolution.

Evolution of optic nerve and retina alterations in a child with indirect traumatic neuropathy as assessed by optical coherence tomography / Evolução das alterações no nervo óptico e na retina em criança com neuropatia traumática indireta avaliadas com tomografia de coerência óptica

ABSTRACT Herein, we describe the case of a 4-year-old child with indirect traumatic optic neuropathy and serial changes of the optic nerve head and retinal nerve fiber layer (RNFL) documented using optical coherence tomography (OCT). Visual acuity improved despite progressive RNFL thinning and optic disc pallor. We concluded that OCT may be useful for monitoring axonal loss but may not predict the final visual outcome.

RESUMO Descrição do caso de uma criança de 4 anos de idade com neuropatia óptica traumática indireta, cujas alterações no nervo óptico e na camada de fibras nervosas da retina foram documentadas com tomografia de coerência óptica seriadas. A acuidade visual apresentou melhora apesar da diminuição progressiva da camada de fibras nervosas e da palidez do disco óptico. Em conclusão, a tomografia de coerência óptica pode ser útil para monitorar a perda axonal na neuropatia óptica traumática indireta, sem no entanto, predizer o desfecho visual.

"Transorbitario" foreign body after ATV accident / Corpo estranho "transorbitário" após acidente com quadriciclo

Abstract This report aims to show an unusual case of "transorbitário" wooden foreign body causing visual loss due to optic nerve damage on the side contralateral penetration of foreign matter.

Resumo O presente relato tem o objetivo de mostrar um caso incomum de corpo estranho de madeira "transorbitário" que causou perda visual por lesão do nervo óptico do lado contralateral a penetração do corpo estranho.