Afferent Visual

Pathways
DR. IDAM DIWYASTRA
DR. ADI PRADESTA
DR. TEGAR CHANDRA B.R.
 The fovea (+ 1.5 mm, or
1disc diameter) is
The afferent visual
located + 4 mm (or 2.5
pathway begins within
disc diameters) from
the retina
and 0.8 mm lower than
the optic disc

The absence of retinal

receptors over the optic
disc creates a
physiologic scotoma
(the blind spot), located
+ 17° from the fovea

The retinal pigment epithelium
(RPE) is in direct contact with the
retinal photoreceptor cells.
Horizontal, amacrine, and
interplexiform cells (which
communicate horizontally
between neighboring cells) permit
signal processing within the retinal
layers.
Between the outer and inner
retinal layers, the retinal signal
starting in the rods and cones is
processed primarily through the
bipolar cells that connect the
photoreceptors to the retinal
ganglion cells
The glial support cells—Müller cells
and astrocytes—also affect image
processing and probably play a
metabolic role as well.
 There is a variable
ratio of Because of the This radial
photoreceptor cells increased density of arrangement of the
to ganglion cells in ganglion cells axons of the bipolar
different regions of centrally,the bipolar cells (the Henle layer)
the retina. The ratio is cells are oriented is responsible for fluid
highest in the radially within the accumulation in a
periphery and lowest macula. star-shaped pattern.
at the fovea
 Another key anatomical feature of the retina is the
location of the optic disc and the beginning of the
optic nerve nasal to the fovea.

Thus, although ganglion cell fibers coming from the

nasal retina can travel uninterrupted directly to the
disc, those coming from the temporal retina must
avoid the macula by anatomically separating to
enter the disc at either the superior or the inferior
pole

This unique anatomy means that some of the nasal

fibers (nasal within the macula) enter the disc on its
temporal side (papillomacular bundle).
Consists of more than 1 million axons.

Originate in the ganglion cell layer of the retina and extend toward the occipital
cortex.

The optic nerve may be divided into the following 4 topographic areas:

• Intraocular region
• Intraorbital region
• Intracanalicular region
• Intracranial region
 The chiasm is located just
The optic chiasm measures +
Supplied by small branches off anterior to the hypothalamus &
12 mm wide, 8 mm long in the
the proximal anterior cerebral the anterior third ventricle
anteroposterior direction, and
and anterior communicating (forming part of its anterior wall
4 mm thick. It is inclined at
arteries. & causing an invagination) & +
almost 45°.
10 mm above the sella.

The extramacular fibers from

the inferonasal retina cross Extramacular superonasal Extramacular temporal fibers
anteriorly in the chiasm at the fibers cross directly to the remain uncrossed in the
“Wilbrand knee” before opposite tract. chiasm and optic tract.
passing into the optic tract.
 Each optic tract contains ipsilateral temporal and
contralateral nasal fibers from the optic nerves.

Fibers (both crossed and uncrossed) from the upper

retinal projections travel medially in the optic tract;
lower projections move laterally.

The macular fibers adopt a dorsolateral orientation

as they course toward the lateral geniculate body.
 It is an oval, caplike structure
that receives approximately
The lateral geniculate 70% of the optic tract fibers Layers 1, 4, and 6 of the
body, or nucleus, is the within its 6 alternating layers lateral geniculate body
synaptic zone for the of gray and white matter. (4 contain axons from the
higher visual projections. yang atas terminal dari axon contralateral optic nerve.
P cell, 2 inferior dari fiber M
cell)

The 6 layers, numbered

Layers 2, 3, and 5 arise
consecutively from below
from the ipsilateral optic
upward, give rise to the
nerve.
optic radiations.
 From their origin at the lateral
geniculate nucleus, the optic
radiations pass through the
The optic radiations retrolentiform part of the internal
connect the lateral capsule and spread out into three
geniculate body with main bundles:
the cortex of the 1.Inferior bundle (Meyer’s loop)
occipital lobe.
2.central bundle
3.Superior bundle (Baum’s loop)
Inferior Bundle (Meyer Loop)

 The inferior bundle (meyer loop) travels anterolaterally along the

roof the temporal horn of the lateral ventricle prior to taking a sharp
turn anteroinferiorly around the temporal horn of the lateral
ventricle. The anterior bundle then tracks backwards, deep to the
superior and middle gyri of the temporal lobe, remaining lateral to
the temporal horn of the lateral ventricle. The anterior bundle
synapses in the anteroinferior border of the calcarine sulcus.
Central Bundle and Superior Bundle

 A central bundle of fibres initially traverses laterally over the roof of

the temporal horn of the lateral ventricle, prior to sharply turning
posteriorly and continuing laterally along the occipital horn of the
lateral ventricle. This bundle travels superiorly to the inferior bundle
until synapsing in the posterior calcarine sulcus. The central bundle
travels deep to the superior gyrus of the temporal lobe.

 The superior bundle (Baum’s loop) tracks dorsally & posteriorly. This
bundle terminates in the superior lip of the calcarine sulcus.
Following a synapse in the LGN, the axons travel posteriorly as the optic
radiations to terminate in the primary visual (calcarine) cortex in the occipital
lobe

The primary visual cortex (area broadmann 17) is

arrayed along the horizontal calcarine fissure.
1. AAO The Eye M.D.Association.2016-2017.Neuroopthalmology, BCSC
Section 5.

2. Riordan-Eva Paul, John P.Whitcer. Vaughan & Asbury Oftalmologi Umum edisi 17.
 TERIMA
KASIH

MOHON
SARAN DAN
BIMBINGAN