Pituitary adenoma revealed by paracentral junctional scotoma of traquair.
The term junctional scotoma of Traquair is used to describe a unilateral temporal visual field defect due to pathology of the ipsilateral optic nerve where it joins the chiasm. We report a 26-year-old woman who presented with blurred vision of her left eye. Examination revealed visual acuity of 20/20 OU, AO-HRR color plates 6/6 OD and 4.5/6 OS, and a 0.3 log unit relative afferent pupillary defect on the left side. Computer and Goldmann perimetry revealed a normal visual field OD and a paracentral temporal scotoma OS. Magnetic resonance imaging scan disclosed a sellar mass, expanding mainly into the left suprasellar area. Laboratory findings and pathological studies were consistent with a prolactin-secreting pituitary adenoma. While involvement of the temporal visual field in only one eye (junctional scotoma of Traquair) is found in about 10% of patients with pituitary adenoma, involvement of only the paracentral temporal visual field in one eye is rare (1-2%). Recognition of this rare syndrome is important because careful visual field analysis discloses a vertical step and helps to avoid misdiagnosing optic neuritis.
Mojon
D S
DS
Department of Ophthalmology, Columbia Presbyterian Medical Center, New York, N.Y., USA.
Odel
J G
JG
Rios
R J
RJ
Hirano
M
M
D000328:Adult; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D009898:Optic Disk / Q000473:pathology; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D015175:Prolactinoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D012607:Scotoma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D014792:Visual Acuity; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields