后视路病变是视交叉以后的视觉通路其本身或毗邻结构发生病变，引起视觉功能改变的一类疾病。神经眼科医生比较熟悉枕叶病变引起的对称性同侧偏盲，但枕极(纹状皮质的最后部分)的病变产生中心性对称性同向盲点，此类视野改变容易被忽略或误诊。该文报道一例老年男性患者，因双眼视觉清晰度下降、视物变形就诊。眼科检查：最佳矫正视力：右眼0.8，左眼1.0，FM-100检查提示重度色觉异常，颅脑磁共振成像(magnetic resonance imaging,MRI)提示双侧枕叶脑梗死(右侧枕极部，左侧纹状皮质前部)，24-2 Humphrey视野检查可见双眼同向暗点趋势(不典型)，10-2 Humphrey视野检查可见双眼中心视野同向偏盲(暗点)，故而确诊。后视路病变可引起多种特征性的视野改变，可伴有高级视功能异常及其他神经系统症状和体征，是神经眼科的重要组成部分。该例枕极脑梗死病变产生对称性同向性盲点伴色觉改变患者的诊治过程，提示需关注后视路病变视野改变的多样性及其他视觉功能异常，提高早期诊断率，改善患者预后。

The disease of the posterior visual pathway is a kind of lesion in which the visual pathway itselfor its adjacent structure changes after optic chiasma causes pathological changes, resulting in changes in visual function. Neuro-ophthalmologists are familiar with symmetrical ipsilateral hemianopia caused by occipital lobe lesions, but occipital tip (the last part of the striatal cortex) lesions produce central symmetrical homonymous scotomas, which can easily be overlooked or misdiagnosed. This article reported a case of an olderly male patient treated with decreased binocular visual clarity and distortion. Ophthalmology examination: best corrected visual acuity: 0.8 in the right eye, 1.0 in the left eye; FM-100 examination indicated severe dyschromatopsia; cranial magnetic resonance imaging: infarction of bilateral occipital lobe (right portion of the occipital tip and left anterior portion of striate cortex); 24-2 Humphrey field examination showed a tendency of homonymous scotoma in bilateral eyes (atypical); 10-2 Humphrey field examination showed homonymous hemianopia (scotoma) in the central visual field. These results confirm a diagnosis of the disease of the posterior visual pathway. As an important part of neuro-ophthalmology, the posterior visual pathway can cause various characteristic visual field defects, which can be accompanied by advanced visual dysfunction and other neurological symptoms and signs. The diagnosis and treatment process of this case of occipital tip cerebral infarction with symmetrical homonymous blind spot accompanied by color vision changes suggests that attention should be paid to the diversity of visual field changes and other visual functional abnormalities in the posterior visual pathway lesions, so as to improve the early diagnosis rate and prognosis of the patient s.

目的：系统分析脑卒中后视野缺损患者干预方案的相关研究，识别、归纳及总结干预的具体内容、结局指标和干预效果，为临床实践及未来该领域研究提供参考。方法：采用范围综述研究框架，系统检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、CINAHL、Cochrane Library共9个数据库。检索时限为建库至2024年4月10日。对纳入文献进行筛选、汇总和分析。结果：最终纳入12篇文献，总结脑卒中后视野缺损患者干预方法及结局指标，干预方法包括替代性干预、补偿性干预、恢复性干预等，结局指标包括日常生活活动能力、日常生活扩展活动能力、阅读表现、视野检查等。结论：目前针对脑卒中后视野缺损患者的干预方案内容多样化、证据质量较低、结局指标不统一，有待进一步开展高质量研究探索最佳训练计划和规范结局指标。未来应不断改进、优化康复策略，建立最佳的多学科结构，制定科学、系统、个性化方案。

Objective: To systematically analyze the related studies on intervention schemes for patients with visual field defects after stroke, and to identify, summarize, and summarize the specific content, outcome indicators, and intervention effects, thereby providing a reference for clinical practice and future research in this field. Methods: Utilizing the scoping review method, a systematic search was conducted in 9 databases: CNKI, CQVIP, Wanfang Database, China Biomedical Literature Database, PubMed, Web of Science, Embase, CINAHL and the Cochrane Library. The search encompassed the period from the inception of each database to April 10, 2024. The selected literature was subsequrently screened, summarized, and analyzed. Results: A total of 12 articles were finally included, summarizing the intervention methods and outcome indicators for patients with visual field defects after stroke. The intervention methods comprised alternative intervention, compensatory intervention, and rehabilitative interventions. Outcome indicators include daily living activities, daily living extended activities, reading performance and visual field examination. Conclusion: Current intervention schemes for patients with visual field defects after stroke exhibit diverse content, charaterized by low evidence quality and inconsistent outcome indicators. Further high-quality research is needed to explore optimal training plans and standardize the outcome indicators. In the future, continuous improvement and optimization of rehabilitation strategies should be carried out to establish the best multidisciplinary framework and formulate scientific, systematic and individualized plans.

目的：探讨原发性慢性闭角型青光眼(chronic primary angle-closure glaucoma，CPACG)患者的视网膜血流密度(vessel density，VD)与视野缺损程度的相关性。方法：光学相干断层血管成像技术(optical coherence tomography angiography，OCTA)测量89例(112眼)视野缺损的CPACG患者的黄斑区VD、视盘旁VD，分析VD与视野缺损程度的相关性。结果：视盘旁VD与视野缺损程度成负相关(r>–0.728，P<0.05)。黄斑浅层总VD的受试者工作曲线(receiver operating characteristic，ROC)及曲线下面积(area under the curve，AUC)为0.874。在控制年龄、眼压及视力的情况下，黄斑总浅层VD每降低1%，视野平均缺损(mean deviation，MD)值增加–0.639 dB。结论：CPACG患者VD与视野缺损呈线性负相关，OCTA可以方便无创地观察青光眼患者眼底血流情况，在视野缺损前发现视网膜VD降低，从而可以作为CPACG早期诊断的参考指标。

Objective: To investigate the correlation between the retinal vessel density (VD) and the degree of visual field loss in chronic primary angle-closure glaucoma (CPACG). Methods: Eighty-nine CPACG patients (112 eyes)with different degrees of visual field loss were measured with optical coherence tomography angiography (OCTA) for macular VD and para-optic microcirculation VD, and the correlation between them and the degree of visual field defect were analyzed. Results: There was a negative correlation between the VD of the microcirculation in each zone next to the optic disc and the degree of visual field loss (r>–0.728, P<0.05). The receiver operating characteristic (ROC) and area under the curve (AUC) of the total VD of the superficial macula is 0.874. Under the condition of controlling age, intraocular pressure and vision, for every 1% decrease in the total superficial macular VD, the average visual field defect mean deviation (MD) value increases –0.639 dB. Conclusion: The VD of CPACG patients is linearly negatively correlated with visual field defects. OCTA can conveniently and non-invasively observe the blood flow of the fundus in patients with glaucoma. It is found that the retinal VD is reduced before visual field defects, which can be used as a reference index for early diagnosis of CPACG.

目的：了解原发性开角型青光眼(primary open angle glaucoma，POAG)患者视野缺损的进展情况，探讨其发生进展的相关危险因素。方法：回顾性分析2014年1月至2018年7月就诊于北京大学第三医院眼科并有至少4次视野检查的POAG患者。按照患者首次视野检查的平均偏差或平均缺损进行分期。将历次随访视野检查的平均偏差或平均缺损与时间进行线性回归分析，取其斜率(dB/年)。根据平均偏差或平均缺损的斜率将患者分为进展组与无进展组。分析患者视盘周围视网膜神经纤维层(retinal nerve fiber layer，RNFL)厚度损害位置、平均随诊间隔时间、基线视野分期等因素与青光眼视野缺损进展的关系。结果：共纳入128例患者(252只眼)，其中129眼使用Octopus视野计检查随访，基线视野缺损值为(10.91±5.76) dB；123眼使用Humphrey视野计，基线视野偏差值为(–10.62±6.89) dB。视野缺损早、中、晚期的比例分别为26.19%、36.51%和37.30%。进展组31只眼(12.30%)，无进展组221只眼(87.70%)。上下方RNFL都存在重度损害的患者，其视野缺损更易进展(P<0.001)。平均随诊间隔时间≤4个月的患眼，发生进展的比例高于平均随诊间隔时间>4个月的患眼(P=0.058)。基线视野分期、年龄、性别、总随访时间与视野缺损进展未见显著相关性。结论：青光眼患者的视功能损害出现恶化是普遍存在的。上下方RNFL均存在重度损害、随诊间隔时间短与视野缺损进展相关。视神经结构的改变与功能损害具有相关性，结构改变的方位对功能损害进展有提示功能。规律随诊对病情监测有重要意义，对于可能快速进展的患者，应缩短随诊间隔时间。

Objective: To investigate the progression of visual field defect in primary open angle glaucoma (POAG), and to explore the related risk factors for its progression. Methods: A retrospective analysis was performed on patients with POAG who had at least 4 visual field examinations in the Department of Ophthalmology, Peking University Third Hospital from January 2014 to July 2018. The visual field was staged according to the mean deviation or mean defect of the first visual field examination. Linear regression analyses of mean deviation or mean defect were performed against time, and corresponding regression slopes (in decibels per year) were calculated. Patients were divided into progressive and non-progressive groups according to the mean deviation slope or mean defect slope. The relationship between retinal nerve fiber layer (RNFL) thickness lesion location, mean follow-up interval, baseline visual field staging, and the progression of visual field defect in glaucoma were analyzed. Results: A total of 128 patients (252 eyes) were included. Among them, 129 eyes were followed up with an Octopus perimeter, and the average mean defect value of the baseline visual field was 10.91±5.76 dB; while the other 123 eyes were followed up with a Humphrey perimeter, and the average mean deviation value of the baseline visual field was –10.62±6.89 dB. The proportion of early, middle and late visual field defects was 26.19%, 36.51% and 37.30%. There were 31 eyes (12.30%) in the progressive group and 221 eyes (87.70%) in the non-progressive group. Patients with severe damage to both the upper and lower RNFLs had more visual field defects (P<0.001). Patients with an average follow-up interval ≤4 months had a higher rate of progression than those with an average follow-up interval >4 months (P=0.058).There were no significant differences in baseline visual field stage, age, gender, and total follow-up time between the progression and progression-free groups. Conclusion: Deterioration of visual function impairment is common in glaucoma patients. The progression of visual field defects is associated with severe impairments which are present both in the upper and lower RNFLs, and short follow-up intervals. Optic nerve structure changes are related to functional impairment, and the location of structural changes is suggestive of functional impairment progression.Regular follow-up visits are of great significance for disease monitoring. For patients who may progress rapidly, the follow-up interval should be shortened.