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Ophthalmic Images

Optic chiasm

Visualizing the visual pathway

Singh, Apinderpreet; Chhabra, Rajesh; Mehta, Aditi1; Virk, Ramandeep Singh2,

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Indian Journal of Ophthalmology: November 2020 - Volume 68 - Issue 11 - p 2537
doi: 10.4103/ijo.IJO_1163_20
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Bilateral optic nerve confluence at the optic chiasm, anterior cerebral arteries, and anterior communicating artery during endoscopic endonasal resection of a craniopharyngioma compressing chiasm [Fig. 1]. Preoperative visual acuity was 1.4 logMAR units in right (OD) and 0.3 in the left eye with macular branch retinal vein occlusion in OD. Surgery performed using an image-guided protocol with intraoperative monitoring of visual evoked potentials as described by Miyagishima et al.[1] Complete tumor removal was achieved. There was no deterioration of visual function postoperatively.

Figure 1
Figure 1:
Intraoperative image of the bilateral optic nerves, their confluence at the optic chiasm and the anterior cerebral arteries along with the anterior communicating artery during endoscopic endonasal resection of a craniopharyngiomasw

We highlight the importance of a multidisciplinary approach and application of advanced intraoperative technology in the management of lesions affecting the visual pathway.

2.1 Financial support and sponsorship


2.2 Conflicts of interest

There are no conflicts of interest.


Miyagishima T, Tosaka M, Yamaguchi R, Nagaki T, Ishii N, Kojima T, Yoshimoto Y. Extended endoscopic endonasal resection of craniopharyngioma using intraoperative visual evoked potential monitoring: Technical note Acta Neurochir (Wien). 2019;161:2277–84
© 2020 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow