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Updated: Jan 25, 2026
16:49
Multifocal Electroretinograms
Published on: December 4, 2011
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Bilateral Superior Altitudinal Hemianopsia with Macular Involvement Confirmed by Multifocal Visual Evoked Potential
Fabliha Anbar1, Valerie Lerebours2, Saad Shaikh3
1Medical Education and Simulation, University of Central Florida College of Medicine, Orlando, USA.
Cureus
|May 7, 2019
Summary
Bilateral superior altitudinal hemianopsia (BSAH) occurred in a patient due to pituitary microadenoma damage. This rare visual field defect, initially misdiagnosed, highlights the importance of considering pituitary lesions.
Area of Science:
- Ophthalmology
- Neurology
- Endocrinology
Background:
- Pituitary microadenomas can cause visual field defects by compressing adjacent structures.
- Bilateral superior altitudinal hemianopsia (BSAH) is a rare visual impairment characterized by loss of the upper half of the visual field in both eyes.
Observation:
- A 69-year-old female presented with BSAH and macular involvement, initially suspected as malingering.
- The patient had risk factors for ischemic disease, including migraine and hypothyroidism, but imaging revealed no ischemia or infarction.
- A history of pituitary microadenoma was noted, although the lesion had regressed.
Findings:
- The BSAH was attributed to inferior optic chiasm damage caused by the pituitary microadenoma.
- Despite the absence of active ischemia, the prior presence of the microadenoma was considered the etiological factor.
Implications:
- This case underscores the potential for pituitary microadenomas to cause significant visual deficits, even after regression.
- It emphasizes the need for thorough ophthalmological and neurological evaluation in cases of unexplained visual field loss.
- Early recognition and management of pituitary-related visual disturbances are crucial for preventing permanent vision loss.
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