Ocular manifestations of suprasellar tumors.
OBJECTIVE
To determine ocular manifestations of suprasellar tumors and to identify the pre-operative factors that might influence final visual outcomes.


METHODS
Medical records of 69 patients with a diagnosis of suprasellar tumor at Srinagarind Hospital between January 1995 and December 2005 were retrospectively reviewed.


RESULTS
The present study focused on 69 patients (39% men and 61% women) with averaged 37.74 years of age (range, 6 to 75). The duration of symptoms was between 4 days and 5 years (average, 7.7 months). The ocular manifestations included visual loss in 59 (86%), eye pain in six (9%), diplopia in three (4%), and ptosis in one (1%) patient. The respective definite diagnosis were pituitary adenoma, suprasellar meningioma, and craniopharyngioma in 33 (48%), 19 (28%), and 17 (25%) patients. According to the pre-operative visual acuity in the worse eye, seven (10%), seven (10%), and 55 (80%) patients were stratified to Group I (VA 6/5 to 6/12), Group II (VA 6/18 to 6/36), and Group III (VA 6/60 to no vision), respectively. Post-operatively two (29%) patients in Group II and 14 (25%) in Group III had improved visual acuity. Three groups of visualfield defect were revealed, viz., Group A (normal visual field), Group B (typical field defect) and Group C (atypical field defect) in seven (10%), 49 (71%), and 13 (19%) patients, respectively. Positive relative afferent pupillary defect was detected in 31 patients (45%) and optic disc atrophy was detected in 26 patients (38%).


CONCLUSIONS
Pituitary adenoma was the most frequent suprasellar tumor and visual loss was the most common ocular presentation. Bitemporal hemianopia frequently occurred in these patients, but was usually asymmetrical and unpredictable in its evolution.
Kitthaweesin
Kitthisak
K
Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. Kitthisak@hotmail.com
Ployprasith
Chatchai
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003397:Craniopharyngioma / Q000473:pathology*; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008579:Meningioma / Q000473:pathology*; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity