Chiasmal and Postchiasmal Disease

Heather E. Moss, MD, PhD, FAAN Neuro-ophthalmology p. 1310-1328 October 2019, Vol.25, No.5 doi: 10.1212/CON.0000000000000785
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PURPOSE OF REVIEW: This article reviews the anatomy, symptoms, examination findings, and causes of diseases affecting the optic chiasm, optic tracts, optic radiations, and occipital lobes.

RECENT FINDINGS: Modern ophthalmic imaging can be used to monitor the effects of diseases of the optic chiasm and tract on the retinal ganglion cells. It can also be used to visualize transsynaptic degeneration of the anterior visual pathway in the setting of acquired retrogeniculate lesions. Visual prostheses that directly stimulate the occipital lobe are a potential strategy for rehabilitation that is in active clinical trials.

SUMMARY: Detecting and characterizing visual deficits due to optic chiasm and retrochiasmal disease are important for the diagnosis, localization, and monitoring of neurologic disease; identifying patient disability; and guiding rehabilitation.

Address correspondence to Dr Heather E. Moss, Spencer Center for Vision Research; 2370 Watson Ct, Ste 200, Palo Alto, CA 94303, hemoss@stanford.edu.

RELATIONSHIP DISCLOSURE: Dr Moss serves on the board of directors of the North American Neuro-Ophthalmology Society and as a review editor for Current Eye Research, an associate editor for Frontiers in Neurology, a section editor for the Journal of Neuro-ophthalmology, and a special section editor for Neuro-ophthalmology. Dr Moss receives research/grant support from the Myelin Repair Foundation, the National Institutes of Health/National Eye Institute (K23 EY024345, P30 EY 026877), and Research to Prevent Blindness and publishing royalties from Elsevier. Dr Moss has served as a legal consultant providing record review and deposition on neuro-ophthalmic diseases.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Moss reports no disclosure.

© 2019 American Academy of Neurology.