Dr.ANCHAL ARORA

Dr. JOLLY ROHATGI, Dr.ASHIT HANDA, Dr.AARUSHI SAINI

Abstract

49 years old male, with no comorbidities presented with progressively decreasing vision in the RE for a month. VA was 6/24,6/6. He could read only the nasal side of the Snellen’s chart from RE. On examination, RE showed disc pallor and temporal field loss (Confrontation field) while LE was WNL. VF 30-2 showed bitemporal hemianopia with involvement of inferonasal field of RE. MRI showed an enlarged sella with lobulated enhancing lesion extending in suprasellar region displacing the chiasma anteriorly and superiorly s/o pituitary macroadenoma. Pituitary hormones were WNL. A trans-sphenoidal excision of the mass was done with marked improvement in visual fields at 3 months followup. VA in RE was 6/12p but the temporal letters were still hazy. Visual field defects may be the first sign of pituitary adenomas. There should be a high index of suspicion in patients with unexplained visual loss and disc pallor. All cases with U/L temporal field loss should be investigated for pituitary tumors.