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PATHWAY
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RETINA
❑ The afferent visual pathway begins within the retina
❑ Absence of retinal receptors over the optic disc physiologic scotoma (the blind
spot), located approximately 17° from the fovea and measuring approximately 5° ×
7°.
❑ The retinal pigment epithelium (RPE) is in direct contact with the retinal
photoreceptor cells. Between the outer and inner retinal layers, the retinal signal
starting is processed primarily through the bipolar cells to the retinal ganglion cells
(RGCs)
RETINA
❑ Horizontal, amacrine, and interplexiform cells signal processing within
the retinal layers.
❑ Glial support cell (Müller cells and astrocytes) affect image processing
and probably play a metabolic role
RETINA
❑ Another key anatomical feature the location of the optic
disc and the beginning of the optic nerve nasal to the fovea.
❑ ganglion cell fibers coming from the nasal retina can
travel directly to the disc
❑ those coming from the temporal retina must avoid the
macula separating to enter the disc at either the
superior or the inferior pole.
❑ Some of the nasal fibers (nasal within the macula) enter
the disc on its temporal side (papillomacular bundle).
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OPTIC NERVE
❑ The optic nerve begins
❑ anatomically at the optic disc
❑ physiologically and functionally within
the ganglion cell layer that covers the
entire retina.
OPTIC CHIASM
OPTIC CHIASM
❑ The inferior nasal retinal fibers are inferior in the anterior chiasm; they cross to
the other side, and many loop into the terminal part of the opposite optic nerve
before turning to run back through the chiasm into the contralateral optic tract.
❑ These anterior loops (anterior knees of Wilbrand) bring fibers from the opposite
eye into the posterior optic nerve. Some investigators believe that these “knees”
are artifacts and suggest that the fibers shift into such a location after loss from
fiber degeneration
❑ The superior nasal fibers enter the superior chiasm, where they cross and then
leave the chiasm in the contralateral optic tract; some of these fibers loop
posteriorly into the optic tract on the same side before crossing. The fibers were
historically called the posterior knees of Wilbrand. The fibers from the temporal
retina course directly back through the chiasm into the optic tract. The nasal
macular fibers also cross and are spread throughout most of the chiasm
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OPTIC TRACT
‣ The fibers exiting from the chiasm proceed
circumferentially around the diencephalon
lateral to the hypothalamus and in contact
with the ambient cistern
K1
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OPTIC RADIATIONS
‣ Following a synapse in the LGN, the axons
travel posteriorly as the optic radiations to
terminate in the primary visual (calcarine)
cortex in the occipital lobe
‣ The most inferior of the fibers first travel
anteriorly, then laterally and posteriorly to
loop around the temporal horn of the lateral
ventricles (Meyer loop)
‣ More superiorly, the fibers travel posteriorly
through the deep white matter of the parietal
lobe.
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OPTIC RADIATIONS
‣ Following a synapse in the LGN, the axons travel
posteriorly as the optic radiations to terminate in the
primary visual (calcarine) cortex in the occipital lobe
‣ The most inferior of the fibers first travel anteriorly, then
laterally and posteriorly to loop around the temporal horn of
the lateral ventricles (Meyer loop)
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OPTIC RADIATIONS
‣ The macular (central) fibers course laterally, with the peripheral fibers concentrated more at the
superior and inferior aspects of the radiations.
‣ Injury to fibers within the radiations produces a homonymous hemianopia, a contralateral visual field
defect that respects the vertical midline.
‣ If the corresponding fibers from the 2 eyes are in close proximity, the field defect is identical in each
eye (congruous).
‣ Congruous field defects occur with lesions involving the calcarine cortex. More anterior involvement
often produces incongruous field defects, suggesting that the corresponding fibers lie farther apart
more anteriorly in the visual pathways.
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‣ The primary visual cortex (known variously as V1, striate cortex, or Brodmann area 17) is
arrayed along the horizontal calcarine fissure, which divides the medial surface of the occipital
lobe.
The primary visual cortex has a thickness of about 2 mm and is organized into horizontal layers and verti-
cal columns.
Layer I, the most super cial layer, contains a few scattered neurons.
Layer II contains neurons that send axons only to deeper cortical layers.
Layer III con- tains neurons that communicate with both near and far cortical locations.
Layer IV contains the stria of Gennari and is subdivided into strata, one of which receives infor- mation
from the magnocellular layers and another that receives information from the parvocellular layers. Layer IV
sends axons to more superficial visual cortex, as well as other visual cortical areas. Layer V sends axons
to the superior colliculus and other areas in the brainstem. Layer VI sends projections back to the LGN.
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BLOOD SUPPLY
‣ The blood supply to the LGN : anterior choroidal artery, lateral choroidal, posterior
choroidal branches of the posterior cerebral artery.
‣ The anterior choroidal artery, a branch of the internal carotid, is a primary supplier of
the optic tract, although small branches from the middle cerebral artery also contribute.
‣ (1) the anterior radiations, which pass laterally over the inferior horn of the
ventricle, are supplied by the anterior choroidal artery and the middle cerebral
artery
‣ (2) the middle group of bers passing lateral to the ventricle is supplied by the deep
optic branch of the middle cerebral artery; and
‣ (3) branches of the posterior cerebral artery, including the calcarine branch, supply
the posterior radiations as they spread out in the occipital lobe. Branches from the
middle cerebral artery also contribute.
‣ The calcarine branch of the posterior cerebral artery is the major blood supply for the
striate cortex, often supplemented by the posterior temporal or parietooccipital branch
of the posterior cerebral artery or the occipital branch of the middle cerebral artery.
Clinical Anatomy & Fisiology of the Visual Field