复旦大学：《眼科学》课程教学课件（英文，Ophthalmology）Neuro-ophthalmology 神经眼科学

Neuro-ophthalmology Min Wang Md PhD Eye and ENT Hospital of Fudan University Department of ophthalmology May192015

Neuro-ophthalmology Min Wang MD PhD Eye and ENT Hospital of Fudan University Department of Ophthalmology May 19, 2015

traduction Definition and Scope of neuro-ophthalmology Neuro-ophthalmology is the subspecialty of ophthalmology and neurology that studies and treats disorders of the part(s of the eye, orbit and nervous system Neuro-ophthalmologists manage patients with complex and severe neuro- ophthalmological disorders The scope of the clinical practice of neuro-ophthalmology varies widely in part because it blends the skills and services of its two parent disciplines; neurology and ophthalmology

Intraduction • Definition and Scope of Neuro-ophthalmology Neuro-ophthalmology is the subspecialty of ophthalmology and neurology that studies and treats disorders of the part(s) of the eye, orbit and nervous system. Neuro-ophthalmologists manage patients with complex and severe neuro￾ophthalmological disorders. The scope of the clinical practice of neuro-ophthalmology varies widely, in part because it blends the skills and services of its two parent disciplines; neurology and ophthalmology

History and Present 1930s Ophthalmologists started neuro ophthalmic work (Frank Walsh, William Hoyt Donald Lyle, etc) 1947 1st Walsh and Hoyt Clinical Neuro-ophthalmology Frank walsh William Hoyt 1960s Neurologists joined neuro ophthalmology Father of neuro-ophthalmology in neurologist paved the way for bringing neurologist into neuro ophthalmology Neil miller Robert daroff

History and Present • 1930’s Ophthalmologists started neuro￾ophthalmic work (Frank Walsh, William Hoyt, Donald Lyle, etc) • 1947 1st Walsh and Hoyt Clinical Neuro-ophthalmology • 1960’s Neurologists joined neuro￾ophthalmology “Father of neuro-ophthalmology in neurologist” “paved the way for bringing neurologist into neuro- ophthalmology” Frank Walsh William Hoyt Neil Miller Robert Daroff

History and present NANOS: North American Neuro-ophthalmology society (1974 INOS: International Neuro- ophthalmology society(1974) EUNOS: Europian Neuro-ophthalmology society (1993) ANOS: Asian Neuro-ophthalmology society (2002 CNOS: Chinese Neuro-ophthalmology society(2011)

• NANOS: North American Neuro- ophthalmology Society (1974) • INOS: International Neuro- ophthalmology Society (1974) • EUNOS: Europian Neuro-ophthalmology Society (1993) • ANOS: Asian Neuro-ophthalmology Society (2002) • CNOS: Chinese Neuro-ophthalmology Society (2011) History and Present

Examination of the afferent and efferent systems Visual fields Orbital diseases Magnetic Resonance Imaging Pupil Optic nerve disorders ystagmus Neuro-ophthalmology Optic chiasm Ocular motor disorders Retrochiasmal disorders Ocular misalignment Nonphysiologic visual loss

Neuro-ophthalmology Examination of the afferent and efferent systems Visual fields Magnetic Resonance Imaging Optic nerve disorders Optic chiasm Retrochiasmal disorders Nonphysiologic visual loss Ocular misalignment Ocular motor disorders Nystagmus Pupil Orbital diseases

Optic Nerve Disorders Opt tic neuritis Neuromyelitis optica Nonarteritic anterior ischemic optic neuropathy (NAION) Leber hereditary optic neuropathy (lhon Papilledema Optic nerve atraphy

Optic Nerve Disorders • Optic neuritis • Neuromyelitis optica • Nonarteritic anterior ischemic optic neuropathy (NAION) • Leber hereditary optic neuropathy (LHON) • Papilledema • Optic nerve atraphy

Anatomy and Physiology of optic Nerve and Visual Pathway 5432 Nerve

Anatomy and Physiology of Optic Nerve and Visual Pathway

Pathway of Optic Nerve a. Intraocular(1-2mm b. Intraobital(25-30mm) C. Intracanalicular(5-9mm) d. Intracranial(9-10mm)

Pathway of Optic Nerve a. Intraocular（1-2mm) b. Intraobital（25-30mm) c. Intracanalicular（5-9mm） d. Intracranial（9-10mm）

GLC

·通过筛板后每个轴突获得 髓鞘,视神经直径增粗 ·视神经通过筛板的高度拥 挤情况是是导致视盘发生 充血水肿的解剖基础 正常视乳头组织切片 ·视神经有鞘膜包裹,由 层脑膜延续而来,依次为 硬脑膜、蛛网膜、软脑膜 视神经鞘膜之间的间隙与 颅内同名间隙相沟通 视乳头水肿组织切片

• 通过筛板后每个轴突获得 髓鞘，视神经直径增粗 • 视神经通过筛板的高度拥 挤情况是是导致视盘发生 充血水肿的解剖基础 • 视神经有鞘膜包裹，由三 层脑膜延续而来，依次为 硬脑膜、蛛网膜、软脑膜 • 视神经鞘膜之间的间隙与 颅内同名间隙相沟通 正常视乳头组织切片 视乳头水肿组织切片