Fraser J Alexander, Newman Nancy J, Biousse Valérie
Departments of Ophthalmology, Neurology, and Neurological Surgery, Neuro-ophthalmology Unit, Emory Eye Center, Emory University School of Medicine, Atlanta, GA 30322, USA.
Handb Clin Neurol. 2011;102:205-21. doi: 10.1016/B978-0-444-52903-9.00014-5.
Disorders of the optic tract, lateral geniculate nucleus, optic radiation, and occipital lobe - collectively called the retrochiasmal visual pathways - are commonly encountered in neurological practice, and may result from a number of causes. The major visual morbidity of retrochiasmal disease is the homonymous visual field defect, which is found in approximately 8% of stroke patients. A homonymous visual field defect may have profound legal, occupational, and financial consequences for patients, with many patients unable to read, drive, or return to work after sustaining retrochiasmal damage. Some homonymous hemianopias may improve, usually within days of a cerebral infarction, but remain stable after 3 months. Although treatment options are limited to those of the underlying cause, appropriate counseling and low-vision rehabilitation may be helpful.
视束、外侧膝状体、视辐射和枕叶的疾病——统称为视交叉后视觉通路——在神经科临床实践中很常见,可能由多种原因引起。视交叉后疾病的主要视觉损害是同向性视野缺损,约8%的中风患者会出现这种情况。同向性视野缺损可能会给患者带来严重的法律、职业和经济后果,许多患者在视交叉后受损后无法阅读、驾驶或重返工作岗位。一些同向性偏盲可能会改善,通常在脑梗死数天内,但3个月后会保持稳定。虽然治疗选择仅限于针对潜在病因的治疗,但适当的咨询和低视力康复可能会有所帮助。