Junctional Scotoma

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Identifier Junctional_Scotoma
Title Junctional Scotoma
Creator Andrew G. Lee, MD; Aryan Pashaei-Marandi
Affiliation (AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (APM) Class of 2021, Baylor College of Medicine, Houston, Texas
Subject Scotomas; Neuroanatomy; Tumors; Visual Field Defects
Description Dr. Lee lectures medical students on junctional scotoma.
Transcript Junctional scotoma-- scotoma means darkness-- junctional means it's at the junction of the optic nerve with chiasm. Fibers from the retina, both the temporal retina and the nasal retina, of the travel in the optic nerve. The nasal fiber represented by this dotted line crosses, but the temporal fiber remains uncrossed. So, the lesion at the junction of the optic nerve and optic chiasm can produce a field defect that only affects the nasal crossing fiber, which will produce a monocular temporal hemianopic optic field defect. Or, it can only press on the temporal uncrossed fiber. If it presses on the temporal fiber, you'll get a monocular nasal field defect. These two field effects are at the junction of the optic nerve and chiasm and are referred to as the junctional scotoma of Traquair. In addition, however, a lesion at the junction of the optic nerve and chiasm could affect a nasal crossing fiber from the other eye, and that means you could get an optic neuropathy field defect in one eye, like a central scotoma. But because there's involvement of the inferonasal crossing fiber from the fellow eye that will produce a superior temporal field defect because of involvement of the inferior nasal fiber from the fellow eye that is also a junctional scotoma. But opposed to the junctional scotoma of Traquair, we just call this the junctional scotoma. The reason this is important is both the junction of scotoma and the junctional scotoma of Traquair are almost always mass lesions at the junction of the optic nerve and chiasm, of which pituitary adenoma, meningioma, craniopharyngioma, and aneurysm are the top causes. So you should learn to recognize both the monocular hemianopia field defect, the junctional scotoma of Traquiar and the contralateral superior temporal field defect the, junctional scotoma.
Date 2019-03
Language eng
Format video/mp4
Type Image/MovingImage
Collection Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890
Rights Management Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6w70zsw
Setname ehsl_novel_lee
ID 1403721
Reference URL https://collections.lib.utah.edu/ark:/87278/s6w70zsw
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