Red Desaturation and Visual Field Deficits in Detecting Chiasmopathy in Patients with Nonfunctioning Pituitary Macroadenoma

Compression induced by a pituitary tumor on the optic chiasm can generate visual field deficits, yet it is unknown how this compression affects the retinotopic organization of the visual cortex. It is also not known how the effect of the tumor on the retinotopic organization of the visual cortex changes after decompression. The authors used functional MRI (fMRI) to map the retinotopic organization of the visual cortex in a 68-year-old right-handed woman before and 3 months after surgery for a recurrent pituitary macroadenoma. The authors demonstrated that longitudinal changes in visual field perimetry, as assessed by the automated Humphrey visual field test, correlated with longitudinal changes in fMRI activation in a retinotopic manner. In other words, after decompression of the optic chiasm, fMRI charted the recruitment of the visual cortex in a way that matched gains in visual field perimetry. On the basis of this case, the authors propose that fMRI can chart neural plasticity of the visual cortex on an individual basis and that it can also serve as a complementary tool in decision making with respect to management of patients with chiasmal compression.

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Do visual field deficits exacerbate visuo-spatial neglect?

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.53.6.487 ◽

1990 ◽

Vol 53 (6) ◽

pp. 487-491 ◽

Cited By ~ 61

Author(s):

P W Halligan ◽

J C Marshall ◽

D T Wade

Keyword(s):

Visual Field ◽

Spatial Neglect ◽

Visual Field Deficits

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Occipital Lobe Vascular Malformations: Prevalence of Visual Field Deficits and Prognosis after Therapeutic Intervention

Neurosurgery ◽

10.1097/00006123-199809000-00010 ◽

1998 ◽

Vol 43 (3) ◽

pp. 422-422

Author(s):

Jonathan C. Horton

Keyword(s):

Visual Field ◽

Therapeutic Intervention ◽

Vascular Malformations ◽

Occipital Lobe ◽

Visual Field Deficits

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Endoscopic transsphenoidal surgery for resection of pituitary macroadenoma: A retrospective study

PLoS ONE ◽

10.1371/journal.pone.0255599 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255599

Author(s):

Jiun-Lin Yan ◽

Chen-Nen Chang ◽

Pin-Yuan Chen

Keyword(s):

Visual Field ◽

Surgical Outcomes ◽

Transsphenoidal Surgery ◽

Pituitary Tumors ◽

Safe Procedure ◽

Pituitary Macroadenoma ◽

Residual Rate ◽

Surgery Group ◽

Surgical Data ◽

The One

Background The endoscopic transsphenoidal approach is an efficient minimally invasive procedure for removal of pituitary tumors that can be accomplished through a one-hand or two-hand approach. The one-hand procedure through one nostril is more intuitive for surgeons, but maneuvering the instruments can be restrictive. The two-hand procedure using a one-and-half nostril approach provides more precise manipulation. This study aimed to compare the surgical outcomes of one-hand/mono-nostril and two-hand/one-and-half nostril surgeries for resection of large pituitary tumors by a single neurosurgeon. Materials and methods The surgical data of 78 consecutive cases with pituitary macroadenoma (diameter >1 cm) were reviewed retrospectively. Altogether, 30 cases received one-hand/mono-nostril surgery, while 48 cases received two-hand/one-and-half nostril surgery. Postoperative outcomes of the two operations were compared. Results The operative time, hospital stay, residual rate of pituitary macroadenoma, visual field, surgical complications, and re-operative rates were slightly improved in the two-hand/one-and-half nostril surgery group compared with that in the one-hand/mono-nostril surgery group (all p>0.05). However, postoperative hypopituitarism was less frequent (1/48; 2.0%) with the two-hand/one-and-half nostril approach than with the mono-nostril approach (p = 0.004). Similar surgical outcomes were found in all patients with either small or large pituitary tumors, except that the difference in postoperative improvement in visual field change reached statistical significance (p = 0.044). Conclusion A single-surgeon endoscopic endonasal transsphenoidal surgery with two-hand/one-and-half nostril approach is an effective and safe procedure for removal of large pituitary tumors.

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Optic radiation tractography integrated into simulated treatment planning for Gamma Knife surgery

Journal of Neurosurgery ◽

10.3171/jns-07/10/0721 ◽

2007 ◽

Vol 107 (4) ◽

pp. 721-726 ◽

Cited By ~ 36

Author(s):

Keisuke Maruyama ◽

Kyousuke Kamada ◽

Masahiro Shin ◽

Daisuke Itoh ◽

Yoshitaka Masutani ◽

...

Keyword(s):

Visual Field ◽

Treatment Planning ◽

Gamma Knife ◽

Diffusion Tensor ◽

Maximum Dose ◽

Gamma Knife Surgery ◽

Optic Radiation ◽

Imaging Studies ◽

Visual Field Deficits ◽

Neurological Change

Object No definitive method of preventing visual field deficits after stereotactic radiosurgery for lesions near the optic radiation (OR) has been available so far. The authors report the results of integrating OR tractography based on diffusion tensor (DT) magnetic resonance imaging into simulated treatment planning for Gamma Knife surgery (GKS). Methods Data from imaging studies performed in 10 patients who underwent GKS for treatment of arteriovenous malformations (AVMs) located adjacent to the OR were used for the simulated treatment planning. Diffusion tensor images performed without the patient's head being secured by a stereotactic frame were used for DT tractography, and the OR was visualized by means of software developed by the authors. Data from stereotactic 3D imaging studies performed after frame fixation were coregistered with the data from DT tractography. The combined images were transferred to a GKS treatment-planning workstation. Delivered doses and distances between the treated lesions and the OR were analyzed and correlated with posttreatment neurological changes. Results In patients presenting with migraine with visual aura or occipital lobe epilepsy, the OR was located within 11 mm from AVMs. In a patient who developed new quadrantanopia after GKS, the OR had received 32 Gy. A maximum dose to the OR of less than 12 Gy did not cause new visual field deficits. A maximum dose to the OR of 8 Gy or more was significantly related to neurological change (p < 0.05), including visual field deficits and development or improvement of migraine. Conclusions Integration of OR tractography into GKS represents a promising tool for preventing GKS-induced visual disturbances and headaches. Single-session irradiation at a dose of 8 Gy or more was associated with neurological change.

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The Pattern Electroretinogram in Glaucoma Patients with Confirmed Visual Field Deficits

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.05-0238 ◽

2005 ◽

Vol 46 (7) ◽

pp. 2411 ◽

Cited By ~ 47

Author(s):

Donald C. Hood ◽

Li Xu ◽

Phamornsak Thienprasiddhi ◽

Vivienne C. Greenstein ◽

Jeffrey G. Odel ◽

...

Keyword(s):

Visual Field ◽

Pattern Electroretinogram ◽

Visual Field Deficits

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Visual field deficits after epilepsy surgery: a new quantitative scoring method

Acta Neurochirurgica ◽

10.1007/s00701-018-3525-9 ◽

2018 ◽

Vol 160 (7) ◽

pp. 1325-1336 ◽

Cited By ~ 3

Author(s):

Rick H. G. J. van Lanen ◽

M. C. Hoeberigs ◽

N. J. C. Bauer ◽

R. H. L. Haeren ◽

G. Hoogland ◽

...

Keyword(s):

Visual Field ◽

Epilepsy Surgery ◽

Scoring Method ◽

Visual Field Deficits ◽

Quantitative Scoring

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Somatosensory Impairments, Falls History and Fear of Falling in Glaucoma - A Survey Study Approach

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181321651273 ◽

2021 ◽

Vol 65 (1) ◽

pp. 11-15

Author(s):

Caitlin O’Connell ◽

Gadi Wollstein ◽

Ian P. Conner ◽

Mark S. Redfern ◽

Kevin C. Chan ◽

...

Keyword(s):

Visual Field ◽

Older Workers ◽

Daily Living ◽

Fear Of Falling ◽

Survey Study ◽

Risk Of Falling ◽

Study Approach ◽

Increased Risk ◽

Visual Field Deficits ◽

The Relationship

The primary aim was to determine if somatosensory impairments alter the association between falls history and glaucoma severity. A secondary aim was to identify the activities of daily living that cause increased concern related to falling in glaucoma and their association with glaucoma severity. Established questionnaires about falls and fear of falling (FoF) were mailed to participants diagnosed with glaucoma. Ninety-eight participants responded. Self-reported feet numbness and tingling symptoms were used to determine the presence of somatosensory impairments. Self-reported falls in glaucoma are associated with visual field deficits in both eyes, particularly in the presence of somatosensory impairments. In addition, increased FoF levels are linked with worse visual field deficits in both eyes, especially when performing challenging walking tasks. Somatosensory impairments alter the relationship between falls risk and visual field deficits in glaucoma. This information may be helpful in identifying older workers at an increased risk of falling.

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