title: Visual disturbances associated with primary empty sella syndrome in patients with chronic renal failure.
abstract: After describing the main clinical features of primary empty sella syndrome and the main hormonal alterations in chronic renal failure, the authors report the results obtained in a group of 33 patients undergoing dialysis three times a week. Each patient had a complete ophthalmologic examination, with electroretinography and visual-evoked potentials, a complete radiologic examination, including skull stratigraphy (particularly of the sellar and parasellar bony structures), and a computed tomographic scan. In the whole group, visual acuity, ocular and lid motility, and visual fields were normal. In two patients, a slight bilateral papilledema, associated with a P100 latency increase and normal morphology and visual-evoked potentials, was reported. Two patients had initial unilateral papillary pallor associated with P100 amplitude alterations. In all four of these patients, radiologic examination showed a markedly pathologic sellar widening with thickening and double contour image of the floor. The report of a primary empty sella was confirmed by computed tomography in all four cases. The authors discuss the possible etiopathogenic mechanisms of the neuroophthalmologic symptoms associated with this syndrome.
authors.affiliation: University of Rome La Sapienza, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Niutta
authors.forename: G
authors.initials: G
authors.lastname: Scorcia
authors.forename: P
authors.initials: P
authors.lastname: Princi
authors.forename: E
authors.initials: E
authors.lastname: Palombi
authors.forename: R
authors.initials: R
authors.lastname: Perilli
authors.forename: G
authors.initials: G
authors.lastname: Mannino
authors.forename: C
authors.initials: C
authors.lastname: Balacco Gabrieli
mesh_terms: D000328:Adult; D000368:Aged; D004596:Electroretinography; D004652:Empty Sella Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000175:diagnosis; D006435:Renal Dialysis; D012886:Skull / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology*; D014792:Visual Acuity