title: Criteria for early detection of temporal hemianopia in asymptomatic pituitary tumor.
abstract: OBJECTIVE
  To determine new criteria for early detection of temporal hemianopia in patients with asymptomatic pituitary tumor.
  
  
  METHODS
  Fifteen patients without visual symptoms had pituitary tumor and subtle defects or normal visual fields by Goldmann perimetry. Twelve patients with visual symptoms had pituitary adenoma and visual field defects detected by Goldmann perimetry. All were examined by automated perimetry. The relationship between the tumor and the optic chiasm was graded by magnetic resonance imaging (MRI) on a scale of 0-4. Grade number increased with extent of compression. Temporal hemianopia observed by automated perimetry was estimated from normal data (52 normal fields). Vertical step was determined from the number of adjacent pairs along the midline; sensitivity was lower in the temporal field than in the nasal field. Temporal depression was calculated by the quadrant sum of sensitivity.
  
  
  RESULTS
  All patients with symptomatic pituitary adenoma had vertical step and temporal depression in the upper field. Nine of 15 patients without visual symptoms had vertical step or temporal depression. Of nine patients with temporal hemianopia, two of four patients had grade 1 compression, three of five had grade 2, and four of four had grade 3.
  
  
  CONCLUSIONS
  New criteria by automated perimetry could detect temporal hemianopia in patients with asymptomatic pituitary tumor.
authors.affiliation: Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan. fujimoto@ophthalm.m.hiba.ac.jp
authors.forename: N
authors.initials: N
authors.lastname: Fujimoto
authors.forename: N
authors.initials: N
authors.lastname: Saeki
authors.forename: O
authors.initials: O
authors.lastname: Miyauchi
authors.forename: E
authors.initials: E
authors.lastname: Adachi-Usami
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006423:Hemianopsia / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D058609:Visual Field Tests; D014794:Visual Fields