First Author: A.A.Ivanescu UK
Co Author(s): A. Tin-u M. Hiranandani R. Kanitkar D. Assheton D. Yussuf 0 0 0 0 0 0 0 0 0
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Report describe the importance of the careful analysis of visual field and the management of urgent surgical treatment.
Ophthalmology department. St Helens Hospital and and Knowsley NHS Trust.
wo patients were referred to our hospital for the eye evaluation. First case presented with vague eye symptoms such as headache and episodes of blurred vision over the last year, and the second was referred by his optometrist with a suspicious of glaucoma due to the changes in the visual field. A complete ophthalmologic examination including best-corrected visual acuity, slit lamp biomicrosopy, applanation tonometry was unremarkable in both cases. Visual field was performed showing a bitemporal hemianopsia in the first case and respectively incomplete homonymous hemianopsia in the second case. Urgent MRI scan of the head was arranged confirming the presence of pituitary tumour in both cases, followed by an urgent neurosurgical treatment with good results.
Pituitary macroadenoma can cause visual field (VF) defects by compressing the optic chiasm or the optic nerve. The prevalence of VF defects in pituitary adenoma varies, ranging from 9% to 32% as reported in the literature. Because of its anatomical relationship with the optic chiasm, pituitary adenoma typically results in bitemporal hemianopia. However, according to tumor size and optic chiasmal position, a variety of field defects can be produced by pituitary adenoma and the tumor size is a significant factor for the severity of VF defects.
Although the tumours of the pituitary gland are common, they tend to be underdiagnosed, causing serious problems,such as blindness. Visual field test is a very important tool not only to diagnose these tumours but also for their urgent neurosurgical management. A carefully interpretation of the visual field would allow for their diagnosis and urgent surgical treatment, thus leading to the prevention of blindness.