Blurred vision during airline flight reveals prolactinoma.
BACKGROUND
Pituitary adenomas can manifest with a variety of endocrinologic signs and symptoms, including amenorrhea, galactorrhea, infertility, and acromegaly. Because of the anatomic location of the pituitary gland, and its proximity to the optic chiasm and cavernous sinuses, pituitary adenomas can also result in decreased visual acuity, diplopia, ophthalmoplegia, visual-field loss, and optic atrophy. In general, these tumors are slow-growing. However, there are reports in the medical literature of patients with previously undiagnosed brain tumors in whom neurological signs suddenly developed when in higher altitudes.


METHODS
A 47-year-old woman came in for an evaluation of a one-month history of blurry peripheral vision that occurred during-then persisted following--an international flight. Examination and automated visual-field testing revealed a decrease in her best-corrected visual acuity and a bi-temporal hemianopsia. Subsequent examinations by a neurologist and endocrinologist revealed a significant pituitary adenoma-specifically, a prolactinoma. The patient was treated with bromocriptine and has shown a rapid improvement in her visual field and a regression of the tumor, as evidenced by a repeat MRI.


CONCLUSIONS
In this case, the sudden development of the patients symptoms during an airline flight, and the persistence of the symptoms after landing, resulted in the discovery of a prolactinoma.
Bodack
Marie I
MI
SUNY College of Optometry, New York, New York 10036, USA. mbodack@sunyopt.edu
D000531:Altitude; D001359:Aviation; D001971:Bromocriptine / Q000627:therapeutic use; D003940:Diagnostic Techniques, Endocrine; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D005654:Fundus Oculi; D006423:Hemianopsia / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D015175:Prolactinoma / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects
D018491:Dopamine Agonists; D001971:Bromocriptine