Neuro-ophthalmological symptoms in pituitary apoplexy
Journal Title: Офтальмологический журнал - Year 2019, Vol 0, Issue 1
Abstract
Background: Neuro-ophthalmological symptoms in patients with pituitary apoplexy were subjected to analysis. Impaired circulation in pituitary adenoma causes an atypical clinical course of the disease which makes the early diagnosis and provision of medical care difficult. Neuro-ophthalmological manifestations of the disease include loss of vision, visual field defects and oculomotor disturbances. Since the visual loss may present as unilateral or bilateral blindness, the field of this disease is of special importance. Purpose: To investigate neuro-ophthalmological symptoms in patients with pituitary apoplexy before and after treatment. Materials and Methods: Ninety patients with pituitary apoplexy were under surveillance at the Romodanov Neurosurgery Institute between 2014 and 2017. Of these, 44 patients (88 eyes) had visual loss and/or visual field defects, and were included in the main group of the study. Patients underwent clinical and neurological, neuro-ophthalmological, and otoneurological examination (including neuroimaging studies). Results: Acute pituitary apoplexy (54.5% of patients) was characterized by sudden onset of presumably symmetric (50% of patients) chiasmal syndrome, and manifested by mildly or moderately impaired BCVA (39.6% of eyes) and sensitivity to light (60% of eyes), partial bitemporal hemianopia, oculomotor disturbances and absence of ophthalmoscopic changes. In addition, surgical treatment resulted in restoration of visual acuity and visual field in 27 (56.3%) eyes. Subacute pituitary apoplexy (45.5% of patients) was characterized by a gradual development of chiasmal syndrome, with a history of sudden visual function loss, and by presumably severe or very severe visual acuity loss (65% of eyes), light sensitivity loss (67.5% of eyes), and development of primary descending optic nerve atrophy (70% of eyes). In addition, surgical treatment resulted in improvements in visual function in most (65%) eyes; however, compared with acute pituitary apoplexy, a complete restoration of visual function was less frequently observed (15%). Conclusion: Pituitary apoplexy is one of the causes of acute visual loss in neurosurgical disorders. In acute pituitary apoplexy, early diagnosis and surgical treatment resulted in stabilization or improvement in visual acuity from 0.54±0.05 to 0.81±0.03 (p < 0.05), and improvement in visual field defects (as assessed by MD values) from 9.05±0.99 to 4.18±0.81 dB (p < 0.05).
Authors and Affiliations
M. Guk, O. Skobska, L. Zadoianyi, K. Iegorova
Keywords
Related Articles
- EP ID EP492233
- DOI 10.31288/oftalmolzh201914651
- Views 131
- Downloads 0
Choroidal thickness in patients with progressive and stabilized POAG
Purpose: To investigate choroidal thickness in patients with progressive and stabilized primary open-angle glaucoma (POAG). Materials and Methods: Forty-nine patients (87 eyes; age, 52 to 77 years) with stage 1, 2 or 3...
Comparing ultrastructural changes in the rabbit chorioretinal complex after 577-nm and 532-nm laser photocoagulation
Background: There is no unanimously adopted approach to titrating laser parameters in subthreshold retinal laser photocoagulation without ophthalmoscopically visible fundus changes. Purpose: To compare the ultrastructur...
Interrelationship of corneoscleral rigidity, corneal thickness and target IOP levels in patients with unstabilized POAG
Background: To the best of our knowledge, no strict criteria for estimating the probability of glaucomatous progression have been reported. Purpose: To investigate the interrelationship between corneoscleral rigidity, c...
Effect of treatment with carnosin on cataract development in experimental ocular hypertension
Background: Senile cataract and glaucoma are the major age-related and degenerative ocular disorders that can cause loss of vision and blindness. To date, the question of the possible mechanisms involved in the impact of...
Improving the technique for controlled cryogenic destruction of conjunctival tumors located in the projection of the ciliary body onto the sclera: a preliminary report
Background: In case of controlled cryogenic destruction of an epibulbar tumor, making direct temperature measurements in the tumor and surrounding tissues during the treatment process is difficult and dangerous. Infrared...