Her vision was tied down.
A 50-year-old female presented with progressive painless vision loss in the left eye and was subsequently diagnosed to have a pituitary macroadenoma, consistent with a prolactinoma, which was compressing the chiasm primarily on the left and involving the left cavernous sinus. She was treated with oral bromocriptine, resulting in marked shrinkage of the tumor and significant visual field recovery. Subsequently, she again began noting progressive vision loss in both eyes and was initially thought to have pituitary tumor regrowth. Repeat brain MRI, however, showed chiasmal prolapse with inferior tethering into an empty sella. Surgical fat padding to reposition the chiasm resulted in visual improvement with a different visual field pattern in the left eye. The clinical manifestations and etiopathogenesis of the empty sella syndrome are discussed.
Dorotheo
E Ulysses
EU
University of Texas Medical Branch, Galveston, Texas, USA.
Tang
Rosa A
RA
Bahrani
Hasan M
HM
Schiffman
Jade S
JS
Bhatti
M Tariq
MT
Lewis
Stephen B
SB
D000273:Adipose Tissue / Q000637:transplantation; D001971:Bromocriptine / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use; D004652:Empty Sella Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009897:Optic Chiasm / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015175:Prolactinoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011391:Prolapse; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
D018491:Dopamine Agonists; D001971:Bromocriptine