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Related Experiment Videos

Wilbrand's knee: does it exist?

Joung H Lee1, Samuel Tobias, Jeong-Taik Kwon

  • 1Department of Neurosurgery, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. leej@ccf.org

Surgical Neurology
|June 24, 2006
PubMed
Summary
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This study found no clinical evidence for Wilbrand's knee, a theorized loop in the optic nerve (ON). Surgical cases involving the optic nerve-chiasm junction did not produce the predicted visual field defects.

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Anatomy

Background:

  • Wilbrand's knee is a theorized anatomical structure where nasal optic nerve fibers loop into the contralateral optic nerve.
  • Hermann Wilbrand proposed that lesions affecting this knee would cause specific visual field defects, including ipsilateral central scotoma and contralateral superotemporal defects.

Observation:

  • This study retrospectively analyzed 3 patients with lesions affecting the optic nerve (ON) at the optic nerve-chiasm junction.
  • Two patients had ON meningioma, and one had sarcoidosis of the ON. Surgical resection of the ON up to the nerve-chiasm junction was performed to prevent disease extension.

Findings:

  • Post-operative visual perimetry in the 3 patients did not reveal any junctional scotoma.
  • The clinical findings challenge the existence of Wilbrand's knee as a distinct anatomical entity causing predictable visual field defects.

Related Experiment Videos

Implications:

  • The study disputes the clinical relevance of Wilbrand's knee in the anterior visual pathway.
  • These findings may necessitate a re-evaluation of the anatomical understanding and clinical significance of optic nerve pathways and associated visual field defects.