Optic atrophy and chiasm

 

Optic atrophy and chiasm

Optic atrophy

Optic atrophy means disc pallor, from loss of axons, glial proliferation and decreased vascularity that follows many pathological processes, e.g. infarction of the nerve from thromboembolism or following papilloedema, inflammation (demyelinating optic neuritis in MS, syphilis, LHON), optic nerve compression, previous trauma, toxic and metabolic causes (vitamin B12 deficiency, quinine and methyl alcohol ingestion). Optic atrophy is described as consecutive or secondary when it follows papilloedema of any cause. The degree of visual loss depends upon underlying pathology.

Optic chiasm

Bitemporal hemianopic field are the typical defects when a mass compresses the chiasm. Common causes are:

  • pituitary neoplasm
  • meningioma
  • craniopharyngioma
  • secondary neoplasm.

In any case of bilateral visual loss, chiasmal compression must be considered.

Optic tract and optic radiation

Optic tract lesions (which are rare) cause field defects which are homonymous, hemianopic and often incomplete and incongruous. Optic radiation lesions cause homonymous quadrantanopic defects. Temporal lobe lesions (e.g. tumour or infarction) cause upper quadrantic defects, and parietal lobe, lower.

     

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Neurological examination
Anosmia
Cranial nerves
Horner's syndrome
Olfactory nerve
Optic nerve and visual system
Optic neuritis
Papilloedema
Pupil
Nervous System Disorders
Epilepsy
Cerebral stroke
Transient ischaemic attack
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