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List of Figures
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Figure 14-1: Magnetic resonance imaging (MRI) of normal brain in sagittal section (upper left), coronal section (upper right), and axial section (lower left). The white arrows indicate the chiasm. |
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Figure 14-2: The optic pathway. The dotted lines represent nerve fibers that carry visual and pupillary afferent impulses from the left half of the visual field. |
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Figure 14-3: Visual field defects due to various lesions of the optic pathways. |
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Figure 14-4: Occipital lobe abscess. Top: Automated perimetry and tangent screen examination showing homonymous, congruous, paracentral scotoma in right upper visual fields. Bottom: Parasagittal MRI showing lesion involving left inferior calcarine cortex. (Reproduced, with permission, from Horton JC, Hoyt WF: The representation of the visual field in human striate cortex. A revision of the classic Holmes map. Arch Ophthalmol 1991;109:816.) |
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Figure 14-5: Bilateral occipital infarcts with bilateral macular sparing. Top: Tangent screen and superimposed Goldmann visual fields of both eyes showing bilateral homonymous hemianopia with macular sparing, greater in the right hemifield. Bottom: Axial MRI showing sparing of occipital poles. (Reproduced, with permission, from Horton JC, Hoyt WF: The representation of the visual field in human striate cortex. A revision of the classic Holmes map. Arch Ophthalmol 1991;109:816.) |
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Figure 14-6: Examples of optic atrophy. Upper left: Primary optic atrophy due to nutritional amblyopia. Upper right: Secondary optic atrophy with retinochoroidal collaterals (arrows) due to optic nerve sheath meningioma. Lower left: Optic atrophy with optic disk drusen. Lower right: Pallor (atrophy) of right optic disk due to nerve compression by sphenoid meningioma. The left disk is normal. |
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Figure 14-7: Arcuate neuroretinitis due to acute retinal necrosis syndrome. (Reproduced, with permission, from Margolis T et al: Acute retinal necrosis syndrome presenting with papillitis and arcuate neuroretinitis. Ophthalmology 1988;95:937.) |
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Figure 14-8: Mild disk swelling in demyelinative papillitis, with disk leakage on fluorescein angiography. |
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Figure 14-9: Mild papilledema. The disk margins are blurred superiorly and inferiorly by the thickened layer of nerve fibers entering the disk. |
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Figure 14-10: Cerebral hemisphere white matter lesions on MRI associated with acute demyelinative optic neuritis. |
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Figure 14-11: Retinal nerve fiber layer in demyelinating optic neuropathy of multiple sclerosis. The upper temporal nerve fiber bundles show multiple slit-like areas of thinning (arrows) representing retrograde axonal atrophy from subclinical disease in the optic nerve. Vision in the eye was 20/20. |
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Figure 14-12: Bilateral internuclear ophthalmoplegia due to multiple sclerosis. |
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Figure 14-13: Pseudo-Foster Kennedy syndrome due to sequential anterior ischemic optic neuropathy. A: Swollen right optic disk with hemorrhages due to current ischemic episode. B: Atrophy of left optic disk due to previous ischemia. C: Early phase of fluorescein angiogram of right eye showing poor perfusion of optic disk and dilated superficial disk capillaries. D: Late phase of fluorescein angiogram showing disk leakage. |
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Figure 14-14: Acute papilledema with cotton-wool spots and hemorrhages. |
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Figure 14-15: Chronic papilledema with prominent disk swelling, capillary dilation, and retinal folds but few hemorrhages or cotton-wool spots (A) and (B). Fluorescein angiography demonstrates the capillary dilation in its early phase (C) and marked disk leakage in its late phase (D). |
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Figure 14-16: Atrophic papilledema in a child with a cerebellar medulloblastoma. The disk is pale and slightly elevated and has blurred margins. The white areas surrounding the macula are reflected light from the vitreoretinal interface. The inferior temporal nerve fiber bundles are partially atrophic (arrows). |
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Figure 14-17: Large patch of myelinated nerve fibers originating from superior edge of disk. Another smaller patch is present near the inferior nasal border of the disk. (Right eye.) |
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Figure 14-18: Axial MRI of sphenoid wing meningioma causing proptosis. |
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Figure 14-19: MRI of tubular optic nerve sheath meningioma. |
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Figure 14-20: Nutritional amblyopia showing centrocecal scotoma. VA = 20/200. |
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Figure 14-21: Methanol poisoning. Note edema of the retina and optic disk. |
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Figure 14-22: Optic nerve hypoplasia. |
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Figure 14-23: Optic disk coloboma. |
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Figure 14-24: Bilateral tilted optic disks. |
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Figure 14-25: Optic nerve head drusen (A) exhibiting autofluorescence (B). |
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Figure 14-26: Coronal MRI showing large pituitary adenoma elevating and distorting the optic chiasm. |
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Figure 14-27: Sagittal MRI showing contrast enhanced suprasellar craniopharyngioma. |
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Figure 14-28: Occipital hematoma (arrow) resulting from a bleeding arteriovenous malformation. This lesion produced homonymous hemianopia and headache. |
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Figure 14-29: Axial MRI showing parietal meningioma with secondary cerebral edema. |
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Figure 14-30: Diagram of the path of the pupillary light reflex. (Reproduced, with permission, from Walsh FB, Hoyt WF: Clinical Neuro-ophthalmology, 3rd ed. Vol 1. Williams & Wilkins, 1969.) |
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Figure 14-31: Normal pupillary light reactions test. |
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Figure 14-32: Afferent pupillary defect (Marcus Gunn pupil). |
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Figure 14-33: Amaurotic pupillary response. |
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Figure 14-34: Coronal MRI of bilateral acoustic neuromas in neurofibromatosis 2. |
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10.1036/1535-8860.ch14