The Clinical Feature And The Related Factors Of The Posterior Visual Pathway

Neurophthalmology is becoming more and more important in recent 20 years in the field of clinical medicine .It is a frontier branch of science between the neuroscience and the ophthalmology. Because of the refreshment of the knowledge, using the technique of computer to observe ocular movement and field of vision, and the development of CT and MRI,the theory of neurophthalmology has developed more quickly.The disease of posterior visual pathway is a disease of neurophthalmology that is some abnormalities such as the disease of blood vessel and tumor in the posterior visual pathway or around it .As the visual tract ,lateral geniculate body , optic radiation or visual cortex can be involved,the patients often suffer the impaired of visual acuity and visual field .Based on the clinical feature and manifestation of the disease of posterior visual pathway such as the disease of blood vessel and 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 incidence and risk factors of the disease of posterior visual pathway such as the disease of blood vessel and tumor ,and to explore the correlation with the decline in visual acuity and visual field defect .Method: to select 67 cases who were diagnosed with hemorrhage , infarction and tumor in posterior visual pathway .the patients was all treated in the PLA General Hospital from april ,2005 to april,2006.To analyze andstatistics the sex and age of patients , symptom that appear firstly such as the ambiguity of vision, somatasthenia, nausea and vomitting, disorder of consciousness, inarticulate speech, migraine , dizzy and something else, the location of the lesions such as the visual tract ,lateral geniculate body , optic radiation and visual cortex, the character of disease such as hemorrhage ,infarction and tumor, the type of visual field defect , manifestation of imageology and the related risk factors such as blood sugar, blood pressure, cholesterin and triglyeride of blood and so on . In our study the clinical data is compared and analyzed to obtain the age that may cause this disease most easily, the location of lesion that is involved most possibly,the character of this disease that appear in most parts of patients and the related risk factors .Results :1,The numble of patients (age <30) was 12,the numble of patients (age between30 and 50) is 21,and the numble of patients (age >50) is 34 (50.75%) .There were 38 Men(56.72%) in patients.The ratio of men to women is 1.3:1. The smallest age of the patient is 7 years old,and the oldest age is 93 years Old. 2,The incidence of eye symptom that appeared firstly was 44.8% (30 patients).The number of the patients who suffered eye symptom associated with some other symptom was 27 (40.30%). Chief complaint of eye is mostly the ambiguity or decline of eye sight .The number of patients who only had eye symptom without any other symptoms was 3.The patients suffered some other symptoms such as somatasthenia, inarticulate speech, migraine and dizzy. 3,17 patients (25.37%) that included 2 patients caused by lesion in visual tract,4 patients caused by lessen in optic radiation and 11 patients caused by lesion in occipital lobe respectively had the decline of visual acuity in all patients .The incidence of the patients who had decline of vision to the all patients in eachpatients was 66.67%,28.57%,22.00% respectively. 39 patients suffered the lesson of visual field among 67 patients. The number of patients who experienced the homonymous hemianopsia that was the common type of visual field defect was 27,among which there were 1 patients in the visual tract ,9 patients in optic radiation and 17 patients in visual cortex .During the patients who suffered the homonymous hemianopsia ,7 patients also had decline of visual acuity and 20 patients still had good central eye sight ,therefore macular sparing occurred.Some other types of visual field defect included tubular visual field that appeared in 2 patients ,bitemporal hemianopia that appeared in 2 patients ,homonymous superior quadrantanopia that appeared in 3patients, homonymous inferior quadrantanopia that appeared in 1 patients ,and cortical blindness that appeared in 2 patients . 4,The damage of 3 patients was in visual tract, the damage of 14 patients was in optic radiation and that of 50 patients was in occipital lobe respectively in 67 patients .The ratio of patients of each location to all patients was 4.48%,20.89%,74.63% respectively。5,The ratio of the patients who were diagnosed with hemorrhage ,infarction and tumor respectively to the all patients was 28.36%,52.24%,and 19.40%.Anemic infarct was common that occurred in 23 cases.In the 50 patients whose location of lesion was in occipital lobe,the number of patients who were diagnosed with hemorrhage was 14 among whom there were 2 patients who had decline of eye sight and 6 patients who had visual field defect ,the number of patients who were diagnosed with infarction was 30 among whom there were 7 patients who had decline of eye sight and 16 patients who had visual field defect,and the number of patients who were diagnosed with tumor wa 6 among whom there were 2 patients who had decline of eye sight and 2 patientswho had visual field defect. 6,In the all patients ,54 patients had the disase of posterior visual pathway because of the abnormalities of blood vessel. The level of arteriosclerosis of the retina,blood sugar, blood pressure, cholesterin and triglyeride of blood in the senile group (age≥50) respectively was significantly higher than that in the non-senile group(P<0.05).Conclusions:1,the numble of patients (age >50) is more than the other age-group,amomg them the patients is more men than woman .2,eye symptom of the patients who suffer the disase of posterior visual pathway often followed some other symptom in most cases. 3,the lesions of visual auity and visual field often appear。There are some kinds of visual field defect in the all patients,and the homonymous hemianopsia is commom.4,the location of lesion is mostly in the occipital lobe and many patients suffered the infarction.5,blood sugar, blood pressure, cholesterin and triglyeride of blood is the related risk factors in the disase of posterior visual pathway.