Chiasmal Syndromes

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Identifier 91_58
Title Chiasmal Syndromes
Subject Chiasmal Herniation
Description This woman was 61 years old when she underwent initial neuro-ophthalmologic evaluation. Twenty-three years earlier, she had undergone removal of a pituitary adenoma followed by radiation therapy. At that time, she had noted a preoperative visual field defect that improved somewhat after the surgery. Twenty-two years before neuro-ophthalmologic evaluation, she was found to have a mild bilateral superotemporal defect on tangent fields. Thirteen years before diagnosis, she was noted to have chronic open-angle glaucoma OU. One year before neuro-ophthalmologic evaluation, progressive visual field loss OD was noted. Upon initial neuro-ophthalmologic assessment, her best corrected acuities were 20/30 OD and 20/25 OS. Ishihara color plates were 100% correct OU. There was no relative afferent pupillary defect. Motility and corneal sensation were normal. Intraocular pressures were 16 mm Hg OD and 14 mm Hg OS. The visual fields are shown in this image. The right optic disc showed a cup:disc ratio of 0.5, with pallor at 7 o'clock. The rest of the rim was pink. The left disc had a cup:disc ratio of 0.6, breaking to the rim with a notch at 4 o'clock, with pallor temporally>superiorly. The assessment was that, although some visual field loss was due to her pituitary tumor and some to her glaucoma, another part was probably vasculopathic, a result of the chiasm descending into the sella. She has exhibited stable visual function over the ensuing 7 years. Pair with 91_59 and 91_60.
Creator AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology Society
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Type Image
Format image/jpeg
Relation is Part of Case 108
Rights Management Copyright 2002. For further information regarding the rights to this collection, please visit:
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Contributor Primary Larry P. Frohman, MD, UMDNJ-New Jersey Medical School
Source AAO/NANOS Clinical neuro-ophthalmology : image collection for ophthalmic practitioners. American Academy of Ophthalmology [electronic resource], [San Francisco, Calif.] : AAO, c1999.
ARK ark:/87278/s6545n7b
Setname ehsl_novel_aao_nanos
Date Created 2005-06-27
Date Modified 2021-05-06
ID 176981
Reference URL