Killer H E, Laeng H R, Flammer J, Groscurth P
Department of Ophthalmology, Kantonsspital Aarau, Switzerland.
Br J Ophthalmol. 2003 Jun;87(6):777-81. doi: 10.1136/bjo.87.6.777.
To describe the anatomy and the arrangement of the arachnoid trabeculae, pillars, and septa in the subarachnoid space of the human optic nerve and to consider their possible clinical relevance for cerebrospinal fluid dynamics and fluid pressure in the subarachnoid space of the human optic nerve.
Postmortem study with a total of 12 optic nerves harvested from nine subjects without ocular disease. All optic nerves used in this study were obtained no later than 7 hours after death, following qualified consent for necropsy. The study was performed with transmission (TEM) and scanning electron microscopy (SEM).
The subarachnoid space of the human optic nerve contains a variety of trabeculae, septa, and stout pillars that are arranged between the arachnoid and the pia layers of the meninges of the nerve. They display a considerable numeric and structural variability depending on their location within the different portions of the optic nerve. In the bulbar segment (ampulla), adjacent to the globe, a dense and highly ramified meshwork of delicate trabeculae is arranged in a reticular fashion. Between the arachnoid trabeculae, interconnecting velum-like processes are observed. In the mid-orbital segment of the orbital portion, the subarachnoid space is subdivided, and can appear even loosely chambered by broad trabeculae and velum-like septa at some locations. In the intracanalicular segment additionally, few stout pillars and single round trabeculae are observed.
The subarachnoid space of the human optic nerve is not a homogeneous and anatomically empty chamber filled with cerebrospinal fluid, but it contains a complex system of arachnoid trabeculae and septa that divide the subarachnoid space. The trabeculae, septa, and pillars, as well as their arrangement described in this study, may have a role in the cerebrospinal fluid dynamics between the subarachnoid space of the optic nerve and the chiasmal cistern and may contribute to the understanding of the pathophysiology of asymmetric and unilateral papilloedema. All the structures described are of such delicate character that they can not even be visualised with high resolution magnetic resonance imaging (MRI).
描述人视神经蛛网膜下腔内蛛网膜小梁、支柱和中隔的解剖结构及排列，并探讨其对人视神经蛛网膜下腔脑脊液动力学和流体压力可能的临床意义。
对9名无眼部疾病受试者的12条视神经进行尸检研究。本研究中使用的所有视神经均在死亡后7小时内获取，并获得了合格的尸检同意书。研究采用透射电子显微镜（TEM）和扫描电子显微镜（SEM）进行。
人视神经蛛网膜下腔内含有多种小梁、中隔和粗壮的支柱，它们排列在神经脑膜的蛛网膜和软膜层之间。根据其在视神经不同部位的位置，它们在数量和结构上表现出相当大的变异性。在眼球段（壶腹），与眼球相邻处，致密且高度分支的纤细小梁网呈网状排列。在蛛网膜小梁之间，可见相互连接的帆状突起。在眶部的眶中段，蛛网膜下腔被细分，在某些位置甚至可被宽阔的小梁和帆状中隔松散地分隔成腔。在管内段，还观察到少量粗壮的支柱和单个圆形小梁。
人视神经蛛网膜下腔并非一个充满脑脊液的均匀且解剖学上无内容物的腔室，而是包含一个由蛛网膜小梁和中隔组成的复杂系统，该系统将蛛网膜下腔分隔开来。本研究中描述的小梁、中隔和支柱及其排列可能对视神经蛛网膜下腔与视交叉池之间的脑脊液动力学起作用，并可能有助于理解不对称性和单侧视乳头水肿的病理生理学。所描述的所有结构都非常精细，以至于即使使用高分辨率磁共振成像（MRI）也无法可视化。
