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视网膜神经纤维层

视网膜
视网膜剖面示意图,从内向外依次排列,最上方为最内层,其上接玻璃体(未标示)。

视网膜神经纤维层retinal nerve fiber layer,RNFL)简称神经纤维层,又名视层[1](stratum opticum),由视神经纤维延伸而成,在近视盘处最厚,向锯齿缘方向渐渐变薄,位于神经节细胞层内面。

视神经纤维穿过筛板后失去髓鞘,继续穿过脉络膜、视网膜,变成单纯的轴索。

神经纤维到达视网膜内表面后,从入口处发散,集结成束状分布整个表面,并在多处形成丛状结构。

视网膜神经元示意图

大多数纤维为向心分布,是神经节细胞层的细胞的轴索直接延续,但也有少部分是离心分布,并在内丛状层和内核层交错分叉,末端增大。

病理

色素性视网膜炎患者可见视网膜神经纤维层异常变薄,其程度和病情轻重相关。[2] 然而,神经纤维层也会随年龄增长及视觉敏锐度的下降而变薄。[3]在色素性视网膜炎的治疗中,视网膜假体或植入能使缺失的光感受器再生的干细胞时,对保护该层的措施也非常重要,因为它是联系视网膜假体和视神经的基础。

视网膜神经纤维层非常敏感。某些理化过程可兴奋其自然凋亡程序。一些不利的情况会对神经纤维层造成损害,如高眼压,眼压波动过高,炎症,血管性疾病和各种缺氧。 Gede Pardianto(2009)报告了6例超声乳化白内障吸出术后视网膜神经纤维层增厚的病例。[4] 任何眶内手术中的突然波动都可能损伤神经纤维层,这与突发性机械压力造成的突然挤压同理,其突然的减压造成微小的内陷,导致的缺血效应可生成微小气栓,阻塞微血管。[5]

参考资料

本条目来自公有领域《格雷氏解剖学》第20版(1918)的相关文本。

  1. ^ 马龙海; 夏廷德. 关兴华 , 编. 新汉英医学词典. 经济日报出版社. 1994: 1499. ISBN 9787800367823. 
  2. ^ Walia S, Fishman GA, Edward DP, Lindeman M. Retinal nerve fiber layer defects in RP patients.
  3. ^ Oishi A, Otani A, Sasahara M, Kurimoto M, Nakamura H, Kojima H, Yoshimura N. Retinal nerve fiber layer thickness in patients with retinitis pigmentosa.
  4. ^ Pardianto G, Mastering phacoemulsification in Mimbar Ilmiah Oftalmologi Indonesia.2009;10:26.
  5. ^ Pardianto G, Moeloek N, Reveny J, Wage S, Satari I, Sembiring R et al.

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视网膜神经纤维层
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