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1 Primary Sellar Hemorrhagic MelanomaIn December, 1992 a 47 year-old male was admitted for investigation of pituitary tumor. The patient had a 6 month history of occipital, frontal and retro-orbital headaches, associated with fatigue, nausea, decreased appetite and a 20 pound weight loss, decreased libido and arthralgias.Hemorrhagic Melanoma; Pituitary Tumor; Computed Tomography; Primary Sellar Hemorrhagic Melanoma; Hemorrhagic AdenomaNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
2 Stages of Improvement in Visual Fields Following Pituitary Tumor ResectionTo use static threshold perimetry to examine the stages of improvement and the potential for late improvement of visual fields following surgical resection of pituitary adenomas causing visual loss from compression of the anterior visual pathways.Pituitary Tumor Resection; Static Threshold Perimetry; Anterior Visual PathwaysNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
3 Pituitary ApoplexyAbrupt swelling of a pre-existing pituitary tumor produces a dramatic symptom complex which may be its first recognizable manifestation. Because the event may culminate in permanent blindness or death, prompt diagnosis of pituitary apoplexy is of immediate and practical importance in the care of neu...Pituitary Tumor; Pituitary Apoplexy; Pituitary Swelling; Cavernous Sinus Syndrome; Ophthalmoplegia; Anterior Visual Pathway Compression; Computed Tomography; Enlarged Sella TurcicaNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
4 Pituitary Apoplexy RevisitedPatients with pituitary apoplexy typically present with severe headache followed by visual loss and oculomotor nerve pareses, as well as altered level of consciousness and endocrine dysfunction. This potentially devastating clinical course is precipitated by a hemorrhage or infarction into a pre-exi...pituitary apoplexy; pituitary adenoma; pituitary tumorNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
5 Chiasmal Injury in Silent Pituitary Apoplexy Without Evidence of Mass EffectPituitary apoplexy is a clinical syndrome involving either hemorrhage or infarction of a pituitary tumor, which classically presents with a severe acute headache, nausea and visual deficits2. However, several studies have found that the majority of cases involving either radiographic or surgical evi...Neuroimaging; Tumors; Skull Base; Visual FieldsNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
6 Intravascular Lymphoma Causing Sellar Mass Effect and Pituitary ApoplexyIntravascular lymphoma is a rare subtype of large cell non-Hodgkin's lymphoma characterized by proliferation of lymphoma cells within the lumina of small vessels.Pituitary Tumor; Intravascular Lymphoma; Diplopia; Third Nerve Palsy; Horner's SyndromeNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
7 Rarebit Perimetry in Patients with Pituitary AdenomasStandard automated static perimetry utilizes a large field test object (Goldmann III). Because of the redundancy in the visual system, pathology affecting the visual pathways may yield normal standard automated perimetry.Rarebit; Perimetry; Pituitary Tumor; Chiasmal Syndrome; Alternative PerimetryNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
8 Surgical Management of Pituitary TumorsThe spectrum of surgically treated pituitary disease has changed radically in the past 10 years. Currently, 95% of pituitary tumors are approached transsphenoidally rather than by craniotomy.Pituitary Tumor; Transsphenoidal Approach; Pituitary Endocrine Hyperfunction SyndromesNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
9 Radiation Induced Cavernous Hemangioma of the Oculomotor NerveA 63 year old woman presented with progressive double vision over 1 year. Her past medical history was remarkable for a pituitary tumor diagnosed in the 1970s. She underwent transphenoidal resection in 1979 and proton beam irradiation in 1982.Third cranial nerve palsy; Cavernous hemangioma; Diplopia; Radiation treatmentNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
10 Two Unusual Cases of ProlactinomaTwo males, one age 17, the other are 36 presented with unusual manifestations of prolactin-secreting pituitary tumor. The first has a history of hyperparathyroidism with renal calculi. This past summer he had noticed an inability to follow a passed football when directly overhead but not before or ...ProlactinomaNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
11 Reversible Unilateral Visual Field Defect as the Presentation of a Pituitary Adenoma and Cerebral AneurysmBitemporal hemianopsia is a well known sequelae of compression of the optic chiasm, oftentimes by a pituitary tumor. Here we present a case of a patient with unilateral visual symptoms as the presenting sign of a pituitary adenoma and a large cerebral aneurysm.Neuroimaging, Visual fields, TumorsNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
12 Diagnostic Evaluation - Pituitary AdenomaSymptoms and Signs: A. Presenting complaint, Visual symptoms, Headache - most common, Amenorrhea (galactorrhea), Hypopituitarism, B. Initial Neuro-Ophthalmology Signs, Significant decrease - last decade, Field defects, 3. Optic atrophy 4. Oculomotor palsies C. Types of Visual Field Defect 1. Chiasma...Pituitary Adenoma; Pituitary Adenoma Symptoms; Hypothalamic - Pituitary Axis; Anterior Pituitary Function; Non-Secretory Pituitary TumorNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
13 Diagnostic Evaluation - Pituitary AdenomaSymptoms and Signs: A. Presenting complaint, Visual symptoms, Headache - most common, Amenorrhea (galactorrhea), Hypopituitarism, B. Initial Neuro-Ophthalmology Signs, Significant decrease - last decade, Field defects, 3. Optic atrophy 4. Oculomotor palsies C. Types of Visual Field Defect 1. Chiasma...Pituitary Adenoma; Pituitary Adenoma Symptoms; Hypothalamic - Pituitary Axis; Anterior Pituitary Function; Non-Secretory Pituitary TumorNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
14 Pattern Electroretinograms for the Detection of Neural Loss in Patients with Permanent Temporal Visual Field Defect from Chiasmal CompressionSeveral studies have indicated that damage to the retinal ganglion cells can be revealed by pattern electroretinogram (PERG) recordings particularly in patients with glaucoma. The pattern of neural loss in patients with previous chiasmal compression and long-standing field defects may serve as a mod...Pattern Electroretinogram; Band Atrophy of the Optic Nerve; Chiasmal Compression; Pituitary Tumor; Retinal Ganglion Cell LossNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
15 Finite Element Modeling of Chiasmal Compression: Nearer to an Understanding of Bitemporal Hemianopia?The precise mechanism of bitemporal hemianopia (BH) in the context of chiasmal compression is unknown. Previous theories have suggested that the blood supply of the crossing fibres is selectively compromised or that crossing fibres are vulnerable because they occupy the centre of the chiasm where th...Optic Chiasm; Bitemporal Hemianopia; Finite Element Modeling; Chiasmal Compression; Pituitary TumorNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
16 Finite Element Modeling of Chiasmal Compression: Nearer to an Understanding of Bitemporal Hemianopia?The precise mechanism of bitemporal hemianopia (BH) in the context of chiasmal compression is unknown. Previous theories have suggested that the blood supply of the crossing fibres is selectively compromised or that crossing fibres are vulnerable because they occupy the centre of the chiasm where th...Optic Chiasm; Bitemporal Hemianopia; Finite Element Modeling; Chiasmal Compression; Pituitary TumorNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
17 Malignant Parasellar Lesions in ChildrenTumors of the parasellar region comprise approximately 15-20% of intracranial tumors encountered In children. The predominant members in this group are glioma and craniopharyngioma. Meningioma and pituitary tumor are less common causes. Each of these tumors is considered benign but may exhibit signi...Malignant Parasellar Lesions; Glioma; Craniopharyngioma; Meningioma; Germ Cell Tumors; RadiotherapyNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
18 Ocular Neuromyotonia Resolved with OxcarbazepineOcular neuromyotonia is a disorder characterized by tonic contraction of one or more extraocular muscles. The pathophysiology is incompletely understood but thought to be due to damaged myelin sheath in ocular motor nerves, triggering crosstalk between adjacent axons, and subsequent prolonged electr...Ocular Motility; Adult Strabismus with a Focus on DiplopiaNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
19 A Case of Suspected Paclitaxel-Associated MaculopathyDrug-induced cystoid macular edema (CME) is a rare ophthalmologic finding in patients taking paclitaxel, an anti- microtubule agent used to treat solid tumors. We report a case of presumed paclitaxel-related bilateral CME in a patient on palliative paclitaxel/gemcitabine chemotherapy for pancreatic ...Chemotherapy and Radiation Injury; Optic Neuropathy; Tumors; Retina; Diagnostic Tests (ERG, VER, OCT, HRT, mfERG, etc)Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
20 What Did We Learn From COVID-19? Tele-Neuro-Ophthalmology Adoption During A PandemicI will begin where I last left off on March 9, 2020 with my concluding remarks during the NANOS 2020 Telemedicine Symposium at the Annual Meeting on Amelia Island, Florida: We live in interesting times and are at an inflection point in medicine, specifically within our field of neuro-ophthalmology. ...Telemedicine; Neuro-ophthalmology; Utilization; Delivery of CareNeuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
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