Optic Chiasmal Prolapse in Primary Empty Sella Syndrome: A Rare Presentation

Empty sella syndrome is characterized by the flattening or shrinkage of the pituitary gland, resulting in the sella tursica being filled with cerebrospinal fluid. Primary empty sella syndrome(PES) arises without any prior pituitary pathologies, in contrast to secondary empty sella syndrome which occurs post medical, surgical, or radiation treatment of pituitary pathologies. PES involves an anatomical defect in the diaphragma sellae which when coupled with increased intracranial pressure can cause the chiasma to herniate into the sella. This can result in various forms of vision loss, such as bitemporal or binasal hemianopsia, unilateral temporal defects and arcuate scotomas.