Progressive loss of vision caused by asymptomatic pituitary macroadenoma: role of OCT
نویسندگان
چکیده
INTRODUCTION Most pituitary adenomas are clinically inactive. In patients with long-standing compression of the optic chiasm, ganglion cells may undergo axonal degeneration. Spectral domain optical coherence tomography (SD-OCT) is able to identify retinal nerve fiber layer (RNFL) and ganglion cell loss in the retina. We present a case in which SD-OCT was used to diagnose an asymptomatic pituitary macroadenoma. CLINICAL CASE A 48-year-old female presented with progressive vision loss in both eyes. SD-OCT identified atrophy of the ganglion cell and nerve layers, with preservation of outer layers bilaterally. Magnetic resonance imaging of the brain showed a pituitary macroadenoma. The pathological diagnosis was nonfunctioning adenoma. DISCUSSION As macroadenomas enlarge, they can induce uncrossed axon loss, resulting in nasal field defects and reduced visual acuity. In these cases, there is atrophy of the nasal and temporal portions of the optic disc, thus occupying a horizontal band across the disc. SD-OCT is able to identify RNFL loss in eyes with band atrophy of the optic nerve, which correlates with visual field defects found in perimetry. SD-OCT is a useful tool to assess the structural and functional damage of ganglion cells. In our case the SD-OCT demonstrated a symmetrical loss of the RNFL and the ganglion cell layer in both eyes, indicating important optic nerve damage.
منابع مشابه
Pituitary macroadenoma resulting from primary hypothyroidism: A16-year-old girl
Background: Primary hypothyroidism is a common medical condition. It can lead to pituitary adenoma which is usually asymptomatic, but it can also lead to symptomatic macroadenomas which are hard to diagnose due to different clinical presentations. Case presentation: A 16-year-old girl presented for endocrinology consultation prior to neurosurgical operation. She had galactorrhea which was acco...
متن کاملUnusual Complication of Pituitary Macroadenoma: A Case Report and Review
BACKGROUND Pituitary macroadenoma is a common benign tumor that usually presents with visual field defects or hormonal abnormalities. Cerebral infarction can be a complication of a large pituitary adenoma. We report a rare case of bilateral anterior cerebral arteries infarcts by a large pituitary macroadenoma with apoplexy. CASE REPORT A 48-year-old male patient presented with altered conscious...
متن کاملA pediatric case of pituitary macroadenoma presenting with pituitary apoplexy and cranial nerve involvement: case report.
Pituitary adenomas usually arise from the anterior lobe of the pituitary gland and are manifested with hormonal disorders or mass effect. Mass effect usually occurs in nonfunctional tumors. Pituitary adenomas may be manifested with visual field defects or rarely in the form of total oculomotor palsy. Visual field defect is most frequently in the form of bitemporal hemianopsia and superior tempo...
متن کاملSpontaneous regression of one nonfunctioning pituitary macroadenoma associated with abnormal liver enzyme tests
Background: Nowadays, drug and observation are advised to patients with lymphocytic hypophysitis and in some cases with nonfunctioning pituitary macoadenoma, instead of surgery. Case presentation: In this article, we report a woman with nonfunctional pituitary macroadenoma and panhypopitutarism and negative criteria for lymphocytic hypophysitis associated with increased liver enzymes. After thr...
متن کامل