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[Visual field in the Cushing syndrome (author's transl)]
Klinische Monatsblatter Fur Augenheilkunde
|February 1, 1979
Summary
Basophile adenomas, typically not causing optic chiasm lesions, can lead to subtle visual field defects. Precise examination revealed a chiasmal lesion in a patient with typical symptoms, despite normal imaging and hormonal tests.
Area of Science:
- Neuro-oncology
- Ophthalmology
- Endocrinology
Background:
- Basophile adenomas of the pituitary gland are traditionally considered unlikely to cause optic chiasm compression.
- Clinical presentation of pituitary adenomas can vary, impacting surrounding structures.
Observation:
- A 16-year-old female presented with symptoms including adiposis, hypertonia, striae distensae, and a "full moon face."
- Despite normal optic discs, a normal sella turcica on X-ray, and uncharacteristic hormonal findings, detailed visual field examination was performed.
Findings:
- Precise visual field testing using a Goldmann perimeter identified a slight chiasmal lesion.
- The lesion was attributed to inferior pressure, challenging the traditional view of basophile adenoma behavior.
Implications:
- This case highlights the importance of thorough visual field assessment in patients with suspected pituitary adenomas, even with seemingly normal initial evaluations.
- It suggests that basophile adenomas can, in some instances, cause optic chiasm compromise through inferior pressure.
- Early detection of subtle chiasmal lesions is crucial for timely intervention and prevention of further visual impairment.