Osher R H, Shields J A, Layman P R
Arch Ophthalmol. 1979 Jun;97(6):1096-9. doi: 10.1001/archopht.1979.01020010550008.
Twenty patients with melanocytoma of the optic disc underwent Goldmann perimetry and pupillary evaluation. Two patients (10%) had normal visual fields. Three (15%) had minimal blind spot enlargement. Fifteen patients (75%) had a greatly enlarged blind spot, of which ten had concomitant nerve fiber bundle field defects. These consisted of a nasal step in two cases (10%), relative nerve fiber bundle defects in four cases (20%), and an absolute arcuate defect in four cases (20%). The blind spot enlargement relates to the pigmented tumor extended beyond the disc boundary, thereby shading the peripapillary retina. The nerve fiber bundle defects result from injury to the visual axons passing through the nerve head, although the mechanism is uncertain. A Marcus Gunn pupillary sign produced by the melanocytoma was found in six patients (30%), all of whom had a substantial relative or absolute nerve fiber bundle defect.
20例视盘黑色素细胞瘤患者接受了Goldmann视野检查和瞳孔评估。2例患者（10%）视野正常。3例（15%）有轻度盲点扩大。15例患者（75%）有极大的盲点扩大，其中10例伴有神经纤维束视野缺损。这些缺损包括2例（10%）的鼻侧阶梯状缺损、4例（20%）的相对神经纤维束缺损和4例（20%）的绝对弓形缺损。盲点扩大与色素性肿瘤延伸至视盘边界之外有关，从而遮蔽了视乳头周围视网膜。神经纤维束缺损是由于穿过神经乳头的视觉轴突受损所致，但其机制尚不确定。6例患者（30%）发现有黑色素细胞瘤引起的Marcus Gunn瞳孔征，所有这些患者都有明显的相对或绝对神经纤维束缺损。
