Selhorst John B, Chen Yanjun
Department of Neurology and Psychiatry, Saint Louis University, St. Louis, Missouri 63108, USA.
Semin Neurol. 2009 Feb;29(1):29-35. doi: 10.1055/s-0028-1124020. Epub 2009 Feb 12.
The optic nerve is our most important cranial nerve. As it courses from the eyeball to the brain, it is divided into four segments: intraocular, intraorbital, intracanalicular, and intracranial. Four tests are primarily used to assess its functional integrity and detect optic nerve disorders. These tests are described along with key funduscopic findings. The clinical features of both common as well as notable disorders that occur along the four segments are presented. For example, papilledema and anterior ischemic optic neuropathy involve the intraocular segment, dysthyroid optic neuropathy or optic nerve sheath meningiomas affect the intraorbital segment, traumatic optic neuropathy is mainly within the intracanalicular segment, and pituitary tumors and suprasellar masses compromise the intracranial segment. Ancillary clinical symptoms and signs are highlighted that assist the neurologist in understanding and localizing each disorder along one of these segments. The chief means of confirming the diagnosis, often neuroimaging, are given, and common treatment modalities are provided.
视神经是我们最重要的脑神经。当它从眼球延伸至大脑时，可分为四个部分：眼内段、眶内段、管内段和颅内段。主要使用四项检查来评估其功能完整性并检测视神经疾病。这些检查将与关键的眼底检查结果一同进行描述。文中还介绍了沿这四个部分发生的常见及显著疾病的临床特征。例如，视乳头水肿和前部缺血性视神经病变累及眼内段，甲状腺功能异常性视神经病变或视神经鞘膜瘤影响眶内段，外伤性视神经病变主要发生在管内段，垂体肿瘤和鞍上肿物则会损害颅内段。文中突出了辅助性临床症状和体征，以帮助神经科医生理解并确定沿这些部分之一发生的每种疾病的位置。文中给出了通常用于确诊的主要手段，通常是神经影像学检查，并提供了常见的治疗方式。
