O'Connell J E
J Neurol Neurosurg Psychiatry. 1973 Oct;36(5):710-23. doi: 10.1136/jnnp.36.5.710.
The gross anatomy of the optic nerves and chiasma has been studied, and differences in the tension in the crossed and uncrossed fibres after chiasmal displacement have been investigated. The anterior and posterior attachments of the medial and lateral fibres of the nerves have been studied. The chiasma has been dissected under low power microscopy and a three dimensional picture of it developed. Bitemporal hemianopia, as well as associated or independent hemianopic scotomata, results from stretching of the crossing fibres in the chiasma. Binasal hemianopia results from compression of the uncrossed fibres in the optic nerve or chiasma by the anterior cerebral or internal carotid arteries. The compression is effective because it is sharply localized and, probably as a result of pulsation, deeply grooves the nerve with a resulting acute distortion of fibres; it is likely that the lax lateral fibres would be less affected by a more widely spread compression. When this defect develops on top of an existing bitemporal hemianopia, it is believed that its usual cause remains the same. The crossed and uncrossed fibres of the optic chiasma differ not only anatomically in the areas of retina in which they arise but also physically. Tension is the force which occasions bitemporal hemianopia and pressure that which produces nasal field defects.
对视神经和视交叉的大体解剖结构进行了研究，并对视交叉移位后交叉纤维和未交叉纤维的张力差异进行了调查。对神经内侧和外侧纤维的前后附着情况进行了研究。在低倍显微镜下对视交叉进行解剖，并绘制出其三维图像。双颞侧偏盲以及相关或独立的偏盲性暗点是由于视交叉中交叉纤维的拉伸所致。双鼻侧偏盲是由于大脑前动脉或颈内动脉对视神经或视交叉中未交叉纤维的压迫所致。这种压迫之所以有效，是因为它定位精确，而且可能由于搏动作用，使神经出现深深的压痕，导致纤维急剧扭曲；很可能较松弛的外侧纤维受更广泛分布的压迫影响较小。当这种缺陷在现有的双颞侧偏盲基础上出现时，人们认为其常见原因不变。视交叉的交叉纤维和未交叉纤维不仅在其起源的视网膜区域在解剖学上有所不同，在物理特性上也有所不同。张力是导致双颞侧偏盲的力量，而压力是产生鼻侧视野缺损的力量。
