方法：回顾性系列病例研究。收集我院2011-01/2012-06间20例以视力下降为主诉首诊于眼科，视野检查有缺损的患者，行视力检查，裂隙灯检查、眼底、眼压等，详细询问并记录全身病史，分别行头颅、眼眶MRI检查，分析其图像表现。

结果：所选20例患者中，最佳矫正视力(BCVA)0.1～0.3者10例，0.3～0.6者4例，0.6～1.2者6例。 5例视乳头水肿，其中3例为单眼，2例为双眼。眼压均在正常范围。视野检查：象限性缺损11例，右侧同向偏盲伴黄斑回避1例，左侧同向偏盲2例，管状视野3例，生理盲点扩大2例，视野弥漫性缺损1例。MRI检查结果以多发性腔隙性脑梗塞最常见，共10例，急性脑梗塞1例，脑膜瘤、垂体瘤与颅咽管瘤各2例，陈旧性脑出血1例。

结论：MRI可发现引起视力下降的头颅占位性病变与视路病变，以视力下降为主诉的患者在排除眼部疾病引起后，应注意其视路与颅内病变引起的可能性。其中，视野检查是一个发现颅内与其他病变的灵敏指标，怀疑有神经眼科病变的患者都应把视野检查作为必查项目。

METHODS: It was a retrospective cases series study. Twenty patients with visual defect who first visited at ophthalmology department were analyzed. Visual acuity, slit lamp, eyeground examination and intraocular pressure were performed. Medical histories were recorded in detail, the brain and orbit MRI were performed and analyzed.

RESULTS:There were 10 cases with BCVA 0.1-0.3, 0.3-0.6 in 4 cases, 0.6-1.2 in 6 cases, Papilledema in 5 cases, while monocular in 3 cases and binocular in 2 cases. Intraocular pressures were all normal. Visual field examinations showed quadrant hemianopsia in 11 cases, macular sparing with homonymous hemianopsia of right side in 1 case, homonymous hemianopsia of left side in 2 cases, tubular visual field in 3 cases, physiological bind spot expanded in 2 cases, diffusive visual defect in 1 case. The MRI showed multiple lacunar cerebral infarction were the commonest disease which was found in 10 cases, acute cerebral infarction in 1 case, hypophysoma, meningioma and craniopharyngioma each in 2 cases, chronic cerebral hemorrhage in 1 case.

CONCLUSION: MRI can show the visual pathway lesions and other diseases responsible for visual loss. The visual field examination is the sensitive method to detect brain diseases, which should be the necessary exam for suspected neuro-ophthalmology patients.