Optic nerve
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The optic nerve, also known as cranial nerve 2, transmits visual information from the retina to the brain. Derived from the embryonic retinal ganglion cell, a diverticulum located in the diencephalon, the optic nerve does
not regenerate after transection.
Contents
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Anatomy
The optic nerve is the second of twelve paired cranial nerves but is considered to be
part of the central nervous system, as it is derived from an outpouching of the diencephalon during embryonic
development. As a consequence, the fibres are covered with myelin produced byoligodendrocytes, rather than Schwann cells, which are found in the peripheral nervous system, and are encased within the meninges. Peripheral
neuropathies like Guillain-Barré syndrome do not affect the optic
nerve.
The optic nerve is ensheathed in all three meningeal layers (dura, arachnoid,
and pia
mater) rather than the epineurium, perineurium, andendoneurium found in peripheral
nerves. Fibre tracks of the mammalian central nervous system (as opposed to the
peripheral nervous system) are incapable of regeneration, and, hence, optic
nerve damage produces irreversible blindness. The fibres from the retina run along the optic nerve to nine primary visual nuclei in the
brain, whence a major relay inputs into the primary visual cortex.
The optic nerve is composed of retinal ganglion cell axons and support cells.
It leaves the orbit (eye socket) via the optic canal, running
postero-medially towards the optic chiasm, where there is a
partial decussation (crossing) of fibres from the temporal visual fields (the
nasal hemi-retina) of both eyes. The proportion of decussating fibers varies
between species, and is correlated with the degree of binocular vision enjoyed
by a species.[1] Most of the axons of the optic nerve
terminate in the lateral geniculate nucleus from where information is
relayed to the visual cortex, while other axons terminate in the pretectal nucleus and are involved in
reflexive eye movements. Other axons terminate in the suprachiasmatic nucleus and are involved in regulating the sleep-wake cycle. Its
diameter increases from about 1.6 mm within the eye to 3.5 mm in the
orbit to 4.5 mm within the cranial space. The optic nerve component
lengths are 1 mm in the globe, 24 mm in the orbit, 9 mm in the
optic canal, and 16 mm in the cranial space before joining the optic
chiasm. There, partial decussation occurs, and about 53% of the fibers cross to
form the optic tracts. Most of these fibres terminate in the lateral geniculate
body.[2]
From the lateral geniculate body, fibers of the optic radiation pass to the visual cortex in the occipital lobe of the brain. In more
specific terms, fibers carrying information from the contralateral superior
visual field traverse Meyer's loop to terminate in the
lingual gyrus below the calcarine fissure in the occipital lobe, and fibers
carrying information from the contralateral inferior visual field terminate
more superiorly, to the cuneus.
Physiology
The eye's blind spot is a result of the
absence of photoreceptors in the area of the retina
where the optic nerve leaves the eye.
Each human optic nerve contains between 770,000 and 1.7 million
nerve fibers,[3] which are axons of the retinal ganglion cells of one retina. In the fovea, which has high acuity, these ganglion cells connect to as few
as 5 photoreceptor cells; in other areas of retina, they connect to many thousand
photoreceptors.
Role in disease
Damage to the optic nerve typically causes permanent and
potentially severe loss of vision, as well as an abnormal pupillary reflex, which is diagnostically
important. The type of visual field loss will depend on which
portions of the optic nerve were damaged. In general:
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Damage proximal to the optic chiasm
causes loss of vision in the visual field of the same side only.
·
Damage in the chiasm causes loss of
vision laterally in both visual fields (bitemporal hemianopsia). It may occur in large pituitary adenomata.
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Damage distal to the chiasm causes loss
of vision in one eye but affecting both visual fields: The visual field
affected is located on the opposite side of the lesion.
Injury to the optic nerve can be the result of congenital or inheritable
problems like Leber's Hereditary Optic
Neuropathy, glaucoma, trauma, toxicity, inflammation, ischemia,
infection (very rarely), or compression from tumors or aneurysms. By far, the three most common injuries to the optic nerve are
from glaucoma, optic neuritis (especially in those younger than 50 years of
age), and anterior ischemic optic neuropathy (usually in those older than 50).
Glaucoma is a group of diseases
involving loss of retinal ganglion cells causing optic neuropathy in a pattern of peripheral vision loss, initially sparing
central vision.
Optic neuritis is inflammation of the
optic nerve. It is associated with a number of diseases, the most notable one
being multiple sclerosis.
Anterior Ischemic Optic
Neuropathy is a particular type of
infarct that affects patients with an anatomical predisposition and
cardiovascular risk factors.
Optic nerve hypoplasia is the underdevelopment
of the optic nerve causing little to no vision in the affected eye.
Optometrists and Ophthalmologists can
detect and diagnose some optic nerve diseases but, those sub-specialists that
areneuro-ophthalmologists, are often best suited to diagnose and treat
diseases of the optic nerve.
The International Foundation for Optic Nerve
Diseases IFOND sponsors
research and information on a variety of optic nerve disorders and may provide
general direction.
See also
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References
- ^ Textbook of
Veterinary Anatomy, 4th Edition. Dyce, Sack and Wensing
- ^ citationneeded
- ^ Jonas, Jost B.; et
al (May 1992). "Human optic nerve fiber count and optic disc
size". Investigative Opthalmology & Visual Science 33 (6).
External links
·
online case history - Optic nerve analysis
with both scanning laser polarimetry with variable corneal compensation (GDx
VCC) and confocal scanning laser ophthalmoscopy (HRT II - Heidelberg Retina
Tomograph). Also includes actual fundus photos.
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