Arvind L. Tenagi1, Sanya Garg2, Rajesh Y. Shenoy3, S. C. Bubanale4, Mahesh I. Magdum5, Umesh Harakuni6, Smitha K. S7, Bhagyajyothi B. K8
PURPOSE: To evaluate ocular manifestations and visual field changes in patients with Sellar and Suprasellar Tumours.
METHODS: Fifty patients with Sellar and Suprasellar tumours underwent a complete ophthalmic assessment and visual field analysis using the Humphrey Field Analyzer 30-2 program. Visual acuity, duration of symptoms, optic nerve head changes, pattern of visual field defects was noted. RESULTS: 50 patients including 15 male and 35 female subjects with mean age of 35.1±9.9 years and CT/MRI proven Suprasellar tumours 70% pituitary adenoma and 30% craniopharyngiomas were included. 70% cases presented with headache 80% with diminution of vision only 10% with hypothyroidism 50% with abnormal pupillary reaction including RAPD and anisocoria. Mean visual acuity at presentation was 0.46 log MAR. Of 100 eyes, 45 patients (90%) had visual field defects including temporal defects in 35 patients (70%), non-specific defects in 4 patients (20%) and 1patient (10%) without any defect. Optic nerve head changes noted and 5 patients (25%) presented with partial optic atrophy and 10 presented with established papilloedema. Visual field outcomes are correlated with duration of symptoms, optic nerve head changes at presentation and CT/ MRI findings.
CONCLUSION: Visual field defects were present in two thirds of patients at presentation. An overall deterioration in vision and visual fields was noted before surgical resection. A correlation was found between the duration of symptoms, MRI/ CT scan reports and visual field, signifying the importance in early diagnosis of neurological lesions on the basis of ophthalmic examination.
