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在黄斑区作一想象的垂直线,将视网膜分为鼻半及颞半;鼻半的纤维经视神经,在视交叉体部向对侧行去,与对侧眼的颞半的纤维组合成视束,视束绕过大脑脚往后进入外侧膝伏体,视纤维换元之后,成为视放射,直达视皮质.在视交叉体部的前外方为左右视神经,如果蝶鞍区的病变涉及到视交叉近端的视神经,可发生单眼的视野缺损,如一眼偏盲、中心暗点、甚至失明.在视交叉体部的后外方为左右视束的起端.如果蝶鞍区的病变涉及到近视交叉的视束,将发生双眼视野在病灶对侧的半个视野偏盲.除此上述情况之外,视交叉体部附近的病变,则经常发生双颞侧视野缺损.早在1884年 Vossius 首次提出了垂体病可及导致双颞侧视野缺损.其后的临床实践证实了这一观点.我们自己的临床观察也证实了这一观点,并且观察到通过手术或药物治疗可迅速改善或减除这些视野缺损.1948年Traquair 指出这种双颞侧视野缺损,首先系视交叉供血受阻碍所致.学者们对视交叉血液供应作了研究,以期证实 Traquair 的观点.协和医院眼科进行过1000余例视交叉部病例的3000余次视野检查.其中主要为垂体瘤病人(520例肢端肥大,185例泌乳素瘤及91例 ACTH 瘤)也都见到不同型样及不同程度的双颞侧视野缺损.临床的经验及疑点给我们提出以下七个问题.我们把这些问题,作为我们实验研究的背景,进行了两部分的研究.
In the macular area as an imaginary vertical line, the retina is divided into the nasal half and temporal half; nasal half optic fibers through the optic nerve, in the optic chiasm to the contralateral to the line, and the contralateral half of the temporal half of the fiber combination into Beam, depending on the beam around the foot of the brain into the lateral knee after the knee volvulus, depending on the fiber for yuan, a visual radiation, direct visual cortex in the optic chiasm of the anteroposterior external side of the optic nerve, if the lesions involving the sella area To the optic nerve near the optic chiasm, monocular visual field defects can occur, such as hemianopia, dark spots, and even blindness in the optic chiasm at the posterior external body for the left and right visual tract at the beginning of the lesion if the area involved To the myopic crossover optic tract, will occur in half of the field of vision of the binocular vision partial hemianopia. In addition to these circumstances, the optic chiasm lesions near the area, then often double-temporal visual field defects as early as 1884 Vossius It was first proposed that pituitary disease could lead to bilateral temporal visual field defects, and subsequent clinical practice confirms this view, and our own clinical observation confirms this notion and observes that surgery or medication can be rapidly improved or subtracted In addition to these visual field defects. 1948 Tra Quair pointed out that this double-temporal visual field defect, first of all due to obstruction of cross-sectional blood supply.Chicologists on the cross-supply of blood was studied in order to confirm the views of Traquair. Union Medical College Hospital conducted more than 1000 cases of optic chiasm More than 3000 visual field examinations, including pituitary tumor patients (520 cases of acromegaly, 185 cases of prolactinoma and 91 cases of ACTH tumor) also saw different patterns and different degrees of bilateral temporal visual field defects. Clinical experience And doubts give us the following seven questions.We put these issues as the background of our experimental study, conducted a two-part study.