Objective Assessment of Visual Field Defects Caused by Optic Chiasm and Its Posterior Visual Pathway Injury / 法医学杂志

OBJECTIVES@#To investigate the characteristics and objective assessment method of visual field defects caused by optic chiasm and its posterior visual pathway injury.@*METHODS@#Typical cases of visual field defects caused by injuries to the optic chiasm, optic tracts, optic radiations, and visual cortex were selected. Visual field examinations, visual evoked potential (VEP) and multifocal visual evolved potential (mfVEP) measurements, craniocerebral CT/MRI, and retinal optical coherence tomography (OCT) were performed, respectively, and the aforementioned visual electrophysiological and neuroimaging indicators were analyzed comprehensively.@*RESULTS@#The electrophysiological manifestations of visual field defects caused by optic chiasm injuries were bitemporal hemianopsia mfVEP abnormalities. The visual field defects caused by optic tract, optic radiation, and visual cortex injuries were all manifested homonymous hemianopsia mfVEP abnormalities contralateral to the lesion. Mild relative afferent pupil disorder (RAPD) and characteristic optic nerve atrophy were observed in hemianopsia patients with optic tract injuries, but not in patients with optic radiation or visual cortex injuries. Neuroimaging could provide morphological evidence of damages to the optic chiasm and its posterior visual pathway.@*CONCLUSIONS@#Visual field defects caused by optic chiasm, optic tract, optic radiation, and visual cortex injuries have their respective characteristics. The combined application of mfVEP and static visual field measurements, in combination with neuroimaging, can maximize the assessment of the location and degree of visual pathway damage, providing an effective scheme for the identification of such injuries.

Research and Prospect of Visual Event-Related Potential in Traumatic Brain Injury and Visual Function Evaluation / 法医学杂志

Visual event-related potential (ERP) is an electrophysiological technique that objectively reflects the cognitive processing of stimulus from the perspective of detecting and recording neural electrophysiology responses using different paradigms of visual stimuli. Its endogenous components are closely related to advanced psychological activities. This article introduces the characteristics of main endogenous components including visual mismatch negativity (vMMN), N200 and P300, reviews the research progress of visual ERP in the sequelae of brain injury and objective evaluation of visual function, and prospects the application prospect of visual ERP in the field of forensic medicine.

Development of Standards of Disability in China and Comparison with Foreign Countries / 中国康复理论与实践

Objective:To discuss the technical standards of disability assessment in personal injury compensation in China, and to put forward the conception of standard construction. Methods:The disability assessment technical standards in China were systematically reviewed, as well as the contents of the United States Guides to the Evaluation of Permanent Impairment (GEPI) and the United Kingdom Guidelines for the Assessment of General Compensation in Personal Injury Cases (GAGD). Results:There were six standards for disability assessment and three of them were commonly used in China at present, coming from different departments. There were some repeated, intertwined, contradictory contents. The disabilities were graded in ten grades, and the disability rate was difference of 10% between two successive grades. The determination of disability grades came from the consensus of specialists, and was little scientific. In comparison, GEPI was developed according to the ICF standards formulated by the World Health Organization, which contained continuous disability value instead of disability grade, along with the weight of organs to calculate synthetically. GEPI emphasizes objective indicators. GAGD directly gave the financial amount of disability compensation. Conclusion:It is needed to integrate the standard management departments of technical standards for disability assessment in China to link standards up; strengthen macro plan and establish the system table of forensic disability assessment standards; carry out international exchanges of technical standards and refer to the concept and data of foreign standards when revising standards.