Chiasmal Syndromes

2011 ◽  
pp. 43-47
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak ◽  
Robert B. Daroff
Keyword(s):  
Visual Field ◽  
Pituitary Apoplexy ◽  
Clinical Signs ◽  
Optic Chiasm ◽  
Visual Field Defects ◽  
Field Defects ◽  
Pituitary Macroadenomas

Dysfunction of the optic chiasm typically produces bitemporal visual field defects. Chiasmal dysfunction most frequently results from compression by extrinsic lesions, such as pituitary macroadenomas and suprasellar meningiomas. We describe the clinical signs of chiasmal dysfunction in this chapter. We also discuss the evaluation and management of pituitary apoplexy.

Chiasmal Syndromes

2019 ◽  
pp. 61-66
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Visual Field ◽  
Clinical Features ◽  
Pituitary Apoplexy ◽  
Optic Chiasm ◽  
Surgical Decompression ◽  
Visual Field Defects ◽  
Pituitary Macroadenoma ◽  
Visual Recovery ◽  
Field Defects ◽  
Pituitary Macroadenomas

Dysfunction of the optic chiasm typically produces bitemporal hemianopic visual field defects. Optic chiasmal dysfunction most often results from compression by extrinsic lesions, such as pituitary macroadenomas and meningiomas. In this chapter, we begin by describing the various bitemporal hemianopic visual field defects that can occur with optic chiasmal dysfunction. We next list potential causes of optic chiasmal dysfunction. We then review the clinical features and evaluation of pituitary apoplexy, which results from infarction of (or hemorrhage into) a pituitary macroadenoma. Lastly, we discuss the management of pituitary apoplexy, including the indications for and timing of surgical decompression, and review factors that affect the prognosis for visual recovery.

Junctional Scotoma and Patterns of Visual Field Defects Produced by Lesions Involving the Optic Chiasm

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Laura C. Donaldson ◽  
Arshia Eshtiaghi ◽  
Simone Sacco ◽  
Jonathan A. Micieli ◽  
Edward A. Margolin
Keyword(s):  
Visual Field ◽  
Optic Chiasm ◽  
Visual Field Defects ◽  
Field Defects

Anatomic Basis and Differential Diagnosis of Field Defects

Visual Fields ◽  
2010 ◽  
Author(s):  
Jonathan D. Wirtschafter ◽  
Thomas J. Walsh
Keyword(s):  
Differential Diagnosis ◽  
Optic Nerve ◽  
Visual Field ◽  
Vision System ◽  
Optic Tract ◽  
Optic Chiasm ◽  
Visual Field Defects ◽  
Medical Test ◽  
Ct Angiogram ◽  
Field Defects

The purpose of any medical test is to confirm or rule out a diagnosis based on the clinical facts. In performing perimetry, the printout of the defect is not the end of the test. For even the most experienced reader, the test results at best tell the location of the defect. The next step is to consider the causes of such a defect in that part of the vision system. The experienced perimetrist will look at the results and suggest a differential list of causes. The primary diagnostic list is frequently aided by adding to the perimetry the medical history and other physical signs. The results of both then lead to the next step: ordering tests to confirm the cause of the field defect. It may require the ordering of a magnetic resonance (MR) image, but that may not be the proper test if the original differential diagnosis is faulty. Sedimentation rate and C-reactive protein may be more appropriate tests if the clinical facts suggest cranial arteritis. If carotid disease is suspected, a computed tomography (CT) angiogram may be more appropriate. In the following discussion of these defects, there has been a melding of a discussion explaining anatomically why these defects occur in certain areas. Because the course and relations of the primary visual sensory pathway have been frequently and well described (including in other chapters of this monograph), this chapter concentrates on the multiple anatomic substrates that may explain each particular pattern of visual field abnormality. Visual field abnormalities are represented by three categories: monocular, binocular, and junctional. Monocular field defects include those that can be caused by lesions of one eye or optic nerve. Binocular field defects include those that may result from single or multiple lesions at one or more points along the visual pathway. Junctional field defects include three types of visual field defects resulting from a lesion at the junction of the optic nerve and optic chiasm or of the optic tract and optic chiasm.

scholarly journals The natural course of non-functioning pituitary macroadenomas

2007 ◽  
Vol 156 (2) ◽  
pp. 217-224 ◽  
Author(s):  
O M Dekkers ◽  
S Hammer ◽  
R J W de Keizer ◽  
F Roelfsema ◽  
P J Schutte ◽  
...  
Keyword(s):  
Visual Field ◽  
Tumor Growth ◽  
Transsphenoidal Surgery ◽  
Tumor Volume ◽  
Visual Fields ◽  
Visual Field Defects ◽  
Pituitary Insufficiency ◽  
Field Defects ◽  
Pituitary Macroadenomas

Objective: The natural history of non-functioning pituitary macroadenomas (NFMA) has not been completely elucidated. Therefore, we evaluated pituitary function, visual fields, and tumor size during long-term follow-up of non-operated patients with NFMA. Design: Follow-up study. Patients: Twenty-eight patients (age 55 ± 3 years) with NFMA, not operated after initial diagnosis, were included. Results: Initial presentation was pituitary insufficiency in 44%, visual field defects in 14%, apoplexy in 14%, and chronic headache in 7% of the patients. The duration of follow-up was 85 ± 13 months. Radiological evidence of tumor growth was observed in 14 out of 28 patients (50%) after duration of follow-up of 118 ± 24 months. Six patients (21%) were operated, because tumor growth was accompanied by visual field defects. Visual impairments improved in all the cases after transsphenoidal surgery. Spontaneous reduction in tumor volume was observed in eight patients (29%). No independent predictors for increase or decrease in tumor volume could be found by regression analysis. Conclusion: Observation alone is a safe alternative for transsphenoidal surgery in selected NFMA patients, without the risk of irreversibly compromising visual function.

Visual Fields

2010 ◽  
Keyword(s):  
Visual Field ◽  
Visual Fields ◽  
Optic Tract ◽  
Optic Chiasm ◽  
Visual Field Defects ◽  
Clinical Aspects ◽  
Automated Perimetry ◽  
Visual Field Examination ◽  
Eye Disorders ◽  
Field Defects

Visual Fields: Examination and Interpretation, 3rd edition contains revisions and updates of earlier material as well as a discussion of newer techniques for assessing visual field disorders. The book begins with a short history of the field of perimetry and goes on to present basic clinical aspects of examination and diagnosis of visual field defects in the optic nerve, optic disc, chorioretina, optic chiasm, optic tract, lateral geniculate field bodies, and the calcarine complex. Additional aspects of visual field examination are explored including those of monocular, binocular, and junctional field defects, congruity vs. incongruity, macular sparing vs. macular splitting, density, wedge-shaped homonymous field loss, and monocular temporal crescent. Various new techniques of automated perimetry are also considered including SITA, FASTPAC, and SWAP. This volume provides a very useful overview of the techniques of visual field examination in a number of eye disorders and will be of interest to all ophthalmologists, neuro-opthalmologists, retina specialists, and optometrists.

scholarly journals Central Visual Field Defects in Patients with Distinct Glaucomatous Optic Disc Phenotypes

2021 ◽  
Vol 223 ◽  
pp. 229-240
Author(s):  
Eren Ekici ◽  
Sasan Moghimi ◽  
Huiyuan Hou ◽  
James Proudfoot ◽  
Linda M. Zangwill ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Disc ◽  
Visual Field Defects ◽  
Central Visual Field ◽  
Field Defects
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