| Neurophthalmology is a frontier branch of science between the neuro-science and the ophthalmology, it covers both ophthalmology and neurology knowledge. Because of anatomical factors, eyes and half of cranial nerves have close relationship. In the central nervous system,38% of the nerve fibers associated with the vision,65% of the intracranial disease can be found in eye's symptoms and signs.The visual pathway have a long path in the brain, when brain tumor growth and violations of the adjacent tissues, it can directly or indirectly caused by compression vision pathways;and vascular supply to the optic tract, optic radiation and visual center was squeezed; and because of increased ICP, the vascular of the visual pathway was extruded on the skeleton or hard connective tissue,so vision fibers was ischemia.so create visual function and eye movement disorder. Eye's symptoms and. signs can diagnosis and localization for brain tumor.Based on the clinical feature and manifestation of the disease of posterior visual pathway such as brain tumor,this kind of disease can be diagnosed and treated early in order to prevent the severe decline of visual acuity and even the damage of the whole body.Object:To investigate the clinical manifestations and features of the disease of posterior visual pathway such as the disease of brain tumor,and to explore the correlation with the decline in visual acuity and visual field defect.Method:To select 55 cases who were diagnosed with tumor in posterior visual pathway .the patients was all treated in the PLA General Hospital from October,2009 to January,2011.To analyze and statistics the sex and age of patients, eye symptom (ambiguity of vision, reduce field of vision, eye distending pain, diplopia, visual hallucination, Optic disc edema,part of the ophthalmoplegia);nervous system symptom(migraine, dizzy, spasm, nausea and vomiting, Limb weakness, auditory dysfunction, recent memory impairment, auditory hallucinations).Distribution of visual acuity, type of visual field defect, the relationship between visual field defect with the course. In our study the clinical data is compared and analyzed to obtain the age that may cause this disease most easily, common clinical features and performance, visual field defect types and the factors affecting the development Results:1,The numble of patients (age<30) was 6,the numble of patients (age between20 and 30) is 9, numble of patients (age between30 and 40) is 9, numble of patients (age between40 and 50) is 13, decline of eye sight (age between50 and 60) is 11,and the numble of patients (age>60) is 7. Middle-aged 40-60 years old accounted for 43.6% of the number of patients.There were majority of male (65.5%) in patients. The ratio of men to women is 1.89:1.2,Eye symptoms:Occurred in 55 patients,37 patients had eye symptoms, including blurred vision in 29 cases(52.7%), smaller field of vision in 12 cases (21.8%), eye pain in 4 cases (7.2%), diplopia in 3 cases (5.4%), visual hallucination in 1 case (1.8%); papilledema in 8 cases (14.5%), part of the eye muscle paralysis in 3 patients (5.4%), visual field defect in 43 cases (78.2%).7 cases (12.7%) with only ocular symptoms at onset. The incidence of eye symptom that appeared firstly was 18 cases (32.7%%).3,Neurological symptoms:Nervous system symptoms:headache,32 patients (58.2%), dizziness in 11 cases (20%), seizure in 11 cases (20%), nausea, vomiting in 9 cases (16.4%), limb weakness in 10 patients (18.2%), auditory dysfunction 2 cases (3.6%), recent memory impairment in 1 case (1.8%) and auditory hallucinations in 1 case (1.8%).4,The distribution of visual acuity: vision<0.2 in 11 patients (20%),0.2≤visual acuity<0.5 in 8 cases (14.5%),0.5≤visual acuity<0.8 in 4 cases (7.3%),0.8≤visual acuity<1.0 (10 cases,18.2%), visual acuity≥1.0 in 22 cases (40%).5,Visual field defect:The rough measurement of the normal field of vision in 12 cases (21.8%), visual field defect in 43 cases (78.2%), of which 6 cases of overlapping hemianopia; non-overlapping Offset field of vision in 23 cases,6 cases with the upward quadrant hemianopia, with the downward quadrant hemianopia in 3 cases, monocular temporal crescent hemianopia in 4 cases,1 case of irregular field defect.6,The incidence of visual field defect with the course of disease of the relationship:duration<1 month of no visual field defect occurred in 4 cases (30.8%), visual field defect in 9 cases (69.2%); 1-6 months:no visual field defects occurred in 5 patients (26.3%), Visual field defect in 14 cases (73.7%); 6-12 months:no visual field defect occurred in 2 cases (20%), visual field defects in 8 cases (80%); 1-5 years:no visual field defect occurred in 1 case (12.5%),Visual field defects in 7 patients (87.5%); 5-9 years no visual field defect occurred in 0 cases (0), visual field defect in 5 cases (100%).Conclusion:1,40-60-year-old middle-aged are more prone to posterior visual pathway involving the brain tumors, more male patients.2,Most patients with ocular symptoms, and many other neurological symptoms associated with the emergence of symptoms,in some patients to eye as the first or only eye symptoms.3,Higher incidence of ipsilateral hemianopsia, in which non-overlapping hemianopia common.4,The incidence of visual field defect was proportional to the prolonged course of disease.5,May occur in some patients complained of disease not consistent with the symptoms.6,Some patients may appear ocular reflex adjustment disorder longly.7,If the patients had blurred vision, migraine headaches, and eye examination without exception, should consider the presence of intracranial tumors. |
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