By Lanning B. Kline, MD
A patient-centered method of the prognosis and remedy of significant neuro-ophthalmic stipulations. concentrating on very important offering symptoms, this e-book leads the reader throughout the occasionally refined manifestations of neuro-ophthalmic sickness to anatomic localization of lesions and definitive analysis. additionally contains an outline of the anatomy of the visible pathway, guidance for carrying out the neuro-ophthalmic exam and acceptable use of diagnostic imaging stories.
Read or Download 2008-2009 Basic and Clinical Science Course: Section 5: Neuro-Ophthalmology (Basic and Clinical Science Course 2008-2009) PDF
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Extra info for 2008-2009 Basic and Clinical Science Course: Section 5: Neuro-Ophthalmology (Basic and Clinical Science Course 2008-2009)
Ganglion cell density in the macula is approximately 60 times that in the periphery. This "central weighting" of neural tissue continues throughout the afferent visual system. In the cortex, the number of cells responding to foveal stimulation may be 1000 times the number associated with peripheral activity. Because of the increased density of ganglion cells centrally (69% within the central 30°), the bipolar cells are oriented radially within the macula. This radial arrangement of the axons of the bipolar cells (Henle's layer) is responsible for fluid accumulation in a starshaped pattern.
The retina measures approximately 2500 mm2 in surface area and is between 100 and 250 /lm thick. The choroid, the extremely vascular posterior extension of the uvea, lines the sclera and supports the single-cell-layer retinal pigment epithelium (RPE). The RPE is in direct contact with the retinal receptors and is responsible for metabolic support as well as regeneration of the chromophore II-trans-retinal to the cis form to restore receptor sensitivity. The impulses that make up the optical signal originate in the ganglion cells within the inner retina.
Central retinal artery (CRA) contribution is restricted to nerve fiber layer capillaries and those of anterior intraorbital optic nerve. Capillary beds at all levels drain into central retinal vein (CRV). ZH = intrascleral circle of Zinn-Haller. RA = recurrent posterior ciliary artery to pial plexus. (Reprintedfrom Kline L8. ed. Optic Nerve Disorders. Ophthalmology Monograph 10. ) collateral supply to the anterior segment. These collaterals may be interrupted if the conjunctiva and Tenon's capsule are removed from the limbus during ocular surgery.