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July 1950


Arch Ophthalmol. 1950;44(1):53-70. doi:10.1001/archopht.1950.00910020056005

OF THE various levels in the visual pathways at which pathologic changes cause characteristic field defects, the chiasmal area is the one where field studies can give the most information as to the site and amount of interference. It is at this level, moreover, that electroencephalography and neurologic examination may show very little. Plain roentgenograms may or may not reveal changes in the sella turcica or the tuberculum sellae. Pneumoencephalography, while often informative, is an uncomfortable, and sometimes even a hazardous, procedure. It is certainly too drastic a procedure for frequent follow-up studies, nor would it show the small variations in chiasmal interference that visual fields reveal. The same is essentially true for arteriography. Ophthalmoscopic study alone is an unreliable and inexact indicator of small variations in interference, because the pallor of optic nerve atrophy may be slow in developing, difficult to differentiate from physiologic temporal pallor and often out

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