Objective Assessment of Visual Field Defects Caused by Optic Chiasm and Its Posterior Visual Pathway Injury.

Autor:	Xiang J; Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China.; Center of Cooperative Innovation for Judicial Civilization, Beijing 100088, China., Wang X; Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China.; Center of Cooperative Innovation for Judicial Civilization, Beijing 100088, China., Yu LL; Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China., Jin KJ; Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China., Yang YK; Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China.
Jazyk:	English; Chinese
Zdroj:	Fa yi xue za zhi [Fa Yi Xue Za Zhi] 2023 Aug 25; Vol. 39 (4), pp. 350-359.
DOI:	10.12116/j.issn.1004-5619.2023.230309
Abstrakt:	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.
Databáze:	MEDLINE
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