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NEURO OPHTHALMOLOGY. Pavel Stodůlka. VISU AL PATHWAY. VISUAL PATHWAY. Clinical point of view :. 1. RETINA 2. OPTICAL NERVE 3. CHIASMA 4. OTICAL TRACT 5. VISUAL CORTEX – area striata. VISUAL PATHWAY. Anatomical point of view:. 1. NEURON – cones & rods - PowerPoint PPT Presentation
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NEURONEURO
OPHTHALMOLOGYOPHTHALMOLOGY
NEURONEURO
OPHTHALMOLOGYOPHTHALMOLOGY
Pavel StodůlkaPavel Stodůlka
VISUAL PATHWAYVISUAL PATHWAY
1. 1. RETINARETINA
2. 2. OPTICAL NERVEOPTICAL NERVE
3. CHIASMA3. CHIASMA
4. 4. OTICAL TRACTOTICAL TRACT
5. 5. VISUAL CORTEX – area striataVISUAL CORTEX – area striata
Clinical point of view:
VISUAL PATHWAYVISUAL PATHWAY
1. 1. NEURON – cones & rodsNEURON – cones & rods
2. 2. NEURON – bipolNEURON – bipolar cells of retinaar cells of retina
33. NEURON - gangli. NEURON - ganglionon cellscells ((nervus opticusnervus opticus))
44. NEURON – . NEURON – cells from corpus cells from corpus
geniculatum lat. geniculatum lat. (radiatio optica)(radiatio optica)
Anatomical point of view:
OPTIC HEAD PATHOLOGYOPTIC HEAD PATHOLOGY
1. PAPIL1. PAPILLEDEMALEDEMA
2. NEURITI2. NEURITISS
3. NEUROPAT3. NEUROPATHYHY
4. 4. OPTIC HEAD OPTIC HEAD ATROATROPHYPHY
OPTIC HEAD PATHOLOGY
OPTIC HEAD PATHOLOGY
1. 1. PAPILLEDEMAPAPILLEDEMA
2. NEURITI2. NEURITISS
3. NEUROPAT3. NEUROPATHYHY
4. 4. OPTIC HEAD OPTIC HEAD ATROATROPHYPHY
PAPILLEDEMAPAPILLEDEMA
It is not a disease It is not a disease
butbut a sign of increased a sign of increased
intracranial (or intraorbital) pressure.intracranial (or intraorbital) pressure.
PAPILLEDEMAPAPILLEDEMA
prominenceprominence
blurry edgesblurry edges
haemorhaemorhhagies agies
““Champane corkChampane cork““
PAPILLEDEMAPAPILLEDEMA
Obvious pathology on the disc Obvious pathology on the disc
but no visual problemsbut no visual problems..
Increased intracranial pressure
Increased intracranial pressure
PPapilapilledemledemaa is present is present
BILATERALBILATERAL..
Increased intracranial pressure
Increased intracranial pressure
Intracranial expansionIntracranial expansion
PAPILLEDEMAPAPILLEDEMA
AbsoluteAbsolute
CCONTRAINDIONTRAINDICATIONCATION
of of lumblumbalal pun puncturecture..
OPTIC HEAD PATHOLOGY
OPTIC HEAD PATHOLOGY
1. PAPIL1. PAPILLEDEMLEDEMAA
2. NEURITI2. NEURITISS
3. NEUROPAT3. NEUROPATHYHY
4. 4. OPTIC HEAD OPTIC HEAD ATROATROPHYPHY
NEURITISNEURITIS
1. NEURITIS 1. NEURITIS INTRAINTRAOCULARISOCULARIS
2. NEURITIS 2. NEURITIS RETRORETROBULBARISBULBARIS
NEURITIS INTRAOCULARIS
NEURITIS INTRAOCULARIS
1. 1. blurry edges of optic headblurry edges of optic head
2. h2. haaemorhagieemorhagiess
3. 3. decreased visual accuitydecreased visual accuity
NEURITIS INTRAOCULARIS
NEURITIS INTRAOCULARIS
brain infectionsbrain infections, meningitis, , meningitis,
infectious diseasesinfectious diseases
Ethiology:
NEURITIS RETROBULBARIS
NEURITIS RETROBULBARIS
Marked visual deteriorationMarked visual deterioration, ,
but no pathologies on optic head.but no pathologies on optic head.
NEURITIS RETROBULBARIS
NEURITIS RETROBULBARIS
Patient does not see anythingPatient does not see anything,,
doctor does not see anything too.doctor does not see anything too.
OPTIC HEAD PATHOLOGY
OPTIC HEAD PATHOLOGY
1. PAPIL1. PAPILLEDEMLEDEMAA
2. NEURITI2. NEURITISS
3. NEUROPAT3. NEUROPATHYHY
4. 4. OPTIC HEAD OPTIC HEAD ATROATROPHYPHY
OPTIC HEAD PATHOLOGY
OPTIC HEAD PATHOLOGY
1. PAPIL1. PAPILLEDEMLEDEMAA
2. NEURITI2. NEURITISS
3. NEUROPAT3. NEUROPATHYHY
4. 4. OPTIC HEAD OPTIC HEAD ATROATROPHYPHY
NEUROPAHTIESNEUROPAHTIES
1. 1. inherited inherited
2. 2. acquiredacquired - a) - a) exogenexogenousous
- b) endogen- b) endogenousous
EXOGENOUS NEUROPATHIES
EXOGENOUS NEUROPATHIES
1. 1. ethanolethanol
2. 2. tabaccotabacco
3. psycho3. psychopharmacspharmacs
4. 4. mmetethanolhanol
METHANOL INTOXICATION
METHANOL INTOXICATION
Patient is sleepy the next day with Patient is sleepy the next day with
vomiting and high heart rate.vomiting and high heart rate.
Delirium and spasms are signs of bad Delirium and spasms are signs of bad
prognosis.prognosis.
If they survive they become blind.If they survive they become blind.
Acute event with dramatic scenario. Acute event with dramatic scenario.
10 ml of methanol is enough for intoxication.10 ml of methanol is enough for intoxication.
METHANOL INTOXICATION
METHANOL INTOXICATION
MetMethhanol anol molecule is been split and molecule is been split and
products are toxic products are toxic
for retinal ganglion cells. for retinal ganglion cells.
METHANOL INTOXICATION
METHANOL INTOXICATION
NEUROPAHTIESNEUROPAHTIES
1. 1. inherited inherited
2. 2. acquiredacquired - a) exogen - a) exogenousous
- - b) endogenb) endogenousous
ENDOGENOUS NEUROPATHIESENDOGENOUS
NEUROPATHIES
1. 1. diabeticsdiabetics
2. 2. pregnancy and brest feedingpregnancy and brest feeding
3. an3. anaaememiaia
4. 4. undernourishmentundernourishment
OPTIC HEAD PATHOLOGY
OPTIC HEAD PATHOLOGY
1. PAPIL1. PAPILLEDEMLEDEMAA
2. NEURITI2. NEURITISS
3. NEUROPAT3. NEUROPATHYHY
4. 4. OPTIC HEAD OPTIC HEAD ATROATROPHYPHY
OPTIC HEAD PATHOLOGY
OPTIC HEAD PATHOLOGY
1. PAPIL1. PAPILLEDEMLEDEMAA
2. NEURITI2. NEURITISS
3. NEUROPAT3. NEUROPATHYHY
4. 4. OPTIC HEAD OPTIC HEAD ATROATROPHYPHY
Optic nerve atrophyOptic nerve atrophy
Manifestation of pathology of Manifestation of pathology of
2. neuron of visual pathway. 2. neuron of visual pathway.
ATROATROPHPHIA SIMPLEXIA SIMPLEX
ATROATROPHPHIA GLAUCOMATOSAIA GLAUCOMATOSA
ATROATROPHPHIIAA FLAVA FLAVA
Optic nerve atrophyOptic nerve atrophy