scholarly journals Ocular form of pituitary tumor Hirsch (Presse med., 1926, № 37)

2021 ◽  
Vol 22 (8) ◽  
pp. 969-969
Author(s):  
S. Repnikov
Keyword(s):  
Visual Acuity ◽  
Pituitary Tumor ◽  
Pituitary Tumors ◽  
Field Of Vision ◽  
Visual Disturbances ◽  
Decrease In Visual Acuity

Hirsch (Presse med., 1926, No. 37) based on 100 operated cases of pituitary tumors, distinguishes, in addition to the commonly mentioned forms, acromegalic and pituitary obesity the ocular form (la forme oculaire). This syndrome is characterized by visual disturbances without significant changes In patients, a decrease in visual acuity and a narrowing of the field of vision are found.

scholarly journals Improvement of Vision after Resection of Pituitary Tumor

2019 ◽  
Vol 15 (3) ◽  
pp. 167-170
Author(s):  
Hari Poudel ◽  
Bikesh Khambu ◽  
Rajendra Shrestha ◽  
Nilam Khadka ◽  
Rajeev Jha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Pituitary Tumor ◽  
Visual Outcome ◽  
Surgical Excision ◽  
Extent Of Resection ◽  
Visual Evaluation ◽  
Field Of Vision ◽  
Visual Status ◽  
Visual Apparatus

Background: Pituitary adenomas are the most common type of pituitary disor­der. Compression of anterior visual apparatus leads to impairment of vision. Visual impairment depends on individual relation between tumor and visual apparatus, duration of compression, timing of operative intervention amongst others. Surgical excision is treatment of choice for tumors causing impairment of vision. Predicting outcome after surgical decompression thus helps both patient and surgeon to make realistic expectations and avoid unnecessary complication from overzealous aggressiveness. Predictors of visual outcome are not well established. This study aims to identify factors that predict visual improvement after resection of pituitary tumor. Methods: A prospective study was planned to study factors associated with visual outcome. Visual acuity was measured by using snellen’s chart and categorized using WHO vision impairment scale for distant vision. Visual field was measured either by Humphrey or Goldmann perimetry. Visual evaluation was done before surgery and after 3 months of surgery. Data was analyzed using SPSS version 23. Results: Twenty-eight eyes of fourteen patients were evaluated. Mean age at presentation was 38 years. Mean duration of impairment of vision at presentation was 13 months. Nonfunctioning pituitary adenoma was the most common pathology. Mean size of tumor was 3.07 cm. Visual acuity improvement was seen in 17(61%) and visual field improvement in 16(57%) of patients. Visual outcome was significantly affected by preoperative visual status and size of tumor. Extent of resection, duration of symptom were not associated with visual outcome. Conclusion: Excision of Pituitary tumor from sella provides enough decompression to anterior visual apparatus resulting in improvement of visual acuity and field of vision. Preoperative visual status and size of tumor can predict postoperative visual outcome.

scholarly journals A case of Gayet-Wernicke encephalopathy with misleading symptoms

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohamed Hadbi ◽  
Dalila Benalakma ◽  
Nadia Fellah
Keyword(s):  
Visual Acuity ◽  
Hyperemesis Gravidarum ◽  
Neurological Complication ◽  
Vitamin Supplementation ◽  
Motor Deficit ◽  
Ophthalmological Examination ◽  
Cerebral Mri ◽  
Sensory Motor ◽  
Brain Stroke ◽  
Decrease In Visual Acuity

Abstract Background The dramatic evolution of incoercible vomiting in pregnancy is at the origin of a rare and serious neurological complication known as EGW; its symptomatology is polymorphic posing a diagnostic problem. MRI is the test of choice for screening. Early vitamin supplementation is essential to improve the maternal-fetal prognosis. Case presentation A 35-year-old parturient, G5P1, without particular pathological history presented incoercible vomiting at 8 weeks, which led to dehydration, undernutrition, and impairment of general condition. Neurological signs: headaches, confused scored at 14 on the Glasgow scale, amnesia, a cerebellar syndrome, sensory-motor deficit. Ophthalmological examination revealed: edema in the eye fundus, a decrease in visual acuity, nystagmus, and ophthalmoplegia. The biological analysis showed moderate hepatic cytolysis. Given the polymorphic neurological symptomatology presented by our parturient, several differential diagnoses were evoked: intracranial hypertension (headache - vomiting - decrease in visual acuity - papillary edema), brain stroke (sensory-motor deficit, ground “pregnancy”), deficit in vitamin B12 (sensory-motor deficit, confusion, memory impairment), and GWE (nystagmus-confusion-ataxia). Cerebral MRI has allowed us to establish the diagnosis of GWE. Conclusion All pregnant with severe hyperemesis gravidarum should be supplemented with thiamine prior to glucose administration to prevent and improve the prognosis of GWE.

Hemorrhagic and nonhemorrhagic Rathke cleft cysts mimicking pituitary apoplexy

2008 ◽  
Vol 108 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Mandy J. Binning ◽  
James K. Liu ◽  
John Gannon ◽  
Anne G. Osborn ◽  
William T. Couldwell
Keyword(s):  
Mr Imaging ◽  
Pituitary Tumor ◽  
Pituitary Apoplexy ◽  
Pituitary Tumors ◽  
Imaging Features ◽  
Mr Images ◽  
Acute Hemorrhage ◽  
Consistent Finding ◽  
Imaging Characteristics ◽  
Intracystic Hemorrhage

Object Rathke cleft cysts (RCCs) are infrequently symptomatic, and apoplexy is one of the most unusual presentations. Only a few cases of apoplexy associated with RCCs have been reported, and their clinical, imaging, surgical, and pathological features are poorly understood. In the cases that have been reported, intracystic hemorrhage has been a consistent finding. The authors report 6 cases of RCCs in which the presenting clinical and imaging features indicated pituitary apoplexy, both with and without intracystic hemorrhage. Methods The authors retrospectively reviewed charts and magnetic resonance (MR) imaging studies obtained in patients who underwent transsphenoidal surgery for RCC. Six patients were identified who presented with symptoms and MR imaging characteristics consistent with pituitary apoplexy but were found intraoperatively to have an RCC. All 6 patients presented with a sudden headache, 2 with visual loss, and 1 with diplopia. Review of the preoperative MR images demonstrated mixed signal intensities in the sellar masses suggestive of a hemorrhagic pituitary tumor. In all patients there was a presumed clinical diagnosis of pituitary tumor apoplexy and an imaging-documented diagnosis of hemorrhagic pituitary tumor. Results All 6 patients underwent transsphenoidal resection to treat the suspected pituitary apoplexy. Intraoperative and histopathological findings were consistent with the diagnosis of an RCC in all cases. Only 2 cases showed evidence of hemorrhage intraoperatively. In all cases, an intracystic nodule was found within the RCC at surgery, and this intracystic nodule was present on the initial MR imaging when retrospectively reviewed. The imaging characteristics of the intracystic nodules were similar to those of acute hemorrhage seen in cases of pituitary apoplexy. Conclusions The clinical and imaging features of RCCs appear similar to those of hemorrhagic pituitary tumors, making them often indistinguishable from pituitary apoplexy.

scholarly journals Visual Quality Assessment of Posterior Capsule Opacification Using Optical Quality Analysis System (OQAS)

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Hui Zhang ◽  
Jing Wang
Keyword(s):  
Visual Acuity ◽  
Quality Assessment ◽  
Case Series ◽  
Optical Quality ◽  
Posterior Capsule Opacification ◽  
Assessment System ◽  
Quality Analysis ◽  
Posterior Capsule ◽  
Case Series Study ◽  
Visual Disturbances

Objective. To evaluate intraocular scattering in eyes with posterior capsule opacification by means of an objective scatter index (OSI) obtained from double-pass images of optical quality assessment system (OQAS TM II) and to determine the indication for laser capsulotomy when patients report visual disturbances without decreased visual acuity. Methods. In this prospective, observational, and nonconsecutive case series study, a total of 32 eyes of 29 patients are diagnosed with posterior capsule opacification after age-associated cataract were analyzed. Patient examination included age, the period after cataract surgery, logMAR best corrected visual acuity (BCVA), and OSI. Results. We found a significant decrease in the BCVA and increase in the OSI with the development of posterior capsule opacification. The decrease of BCVA was statistically correlated with the increase of OSI (r=0.812, P<0.01). In patients who reported visual disturbances without decreased visual acuity, OSI decreased to <1.3 and subjective symptoms were resolved in all cases although there was no significant improvement in visual acuity after laser capsulotomy. Conclusions. The results of our study showed that OSI is also a useful parameter for objectively evaluating posterior capsule opacification. OSI may help predict laser capsulotomy in patients who report visual disturbances without decreased visual acuity.

scholarly journals Visual Acuity, Contrast Sensitivity and Color Vision Three Years After Iodine-125 Brachytherapy for Choroidal and Ciliary Body Melanoma

2015 ◽  
Vol 9 (1) ◽  
pp. 131-135 ◽  
Author(s):  
Irena Tsui ◽  
Robert M Beardsley ◽  
Tara A McCannel ◽  
Scott C Oliver ◽  
Melissa W Chun ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Color Vision ◽  
Ciliary Body ◽  
Case Series ◽  
Vision Measurement ◽  
Corrected Visual Acuity ◽  
Iodine 125 ◽  
Decrease In Visual Acuity ◽  
Ciliary Body Melanoma

Purpose : To report visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after iodine-125 brachytherapy for choroidal and ciliary body melanoma (CCM). Design : Prospective interventional case series. Participants : Thirty-seven patients (37 eyes) with CCM. Methods : Patients had best-corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, Pelli-Robson contrast sensitivity and Hardy-Rand-Rittler color vision measurement; comprehensive ophthalmology examination; optical coherence tomography; and ultrasonography at baseline prior to, 1 year after, 2 years after and 3 years after I-125 brachytherapy. Main Outcome Measures : Visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after brachytherapy. Results : Nineteen (19) men and 18 women with mean age of 58 years (SD 13, range 30-78) prior to, 1 year after, 2 years after and 3 years after brachytherapy had mean best-corrected visual acuity of 77 letters (20/32), 65 letters (20/50), 56 letters (20/80) and 47 letters (20/125); contrast sensitivity of 30, 26, 22 and 19 letters; color vision of 26, 20, 17 and 14 test figures, respectively. Decrease in visual acuity, contrast sensitivity and color vision was statistically significant from baseline at 1 year, 2 years, and 3 years after brachytherapy. Decreased acuity at 3 years was associated with mid-choroid and macula melanoma location, ≥ 4.1 mm melanoma height, radiation maculopathy and radiation optic neuropathy. Conclusion : 1, 2 and 3 years after brachytherapy, eyes with CCM had significantly decreased visual acuity, contrast sensitivity and color vision.

scholarly journals Vision impairment as the first symptom of encephalomyelitis in a paediatric patient

2021 ◽  
Vol 8 (2) ◽  
pp. 93-98
Author(s):  
Aleksandra Świerczyńska ◽  
Małgorzata Woś
Keyword(s):  
Visual Acuity ◽  
Paediatric Patient ◽  
Optic Disc ◽  
Acute Disseminated Encephalomyelitis ◽  
Vision Impairment ◽  
Optic Disc Oedema ◽  
Disc Oedema ◽  
Decrease In Visual Acuity

An 8-year-old boy was admitted to the Ophthalmology Department due to a vision impairment with an accompanying decrease in visual acuity and bilateral optic disc oedema. As a result of interdisciplinary diagnostics, acute disseminated encephalomyelitis, probably related to preceding infection, was diagnosed.

A STUDY OF CLINICAL PRESENTATION AND MANAGEMENT OF PITUITARY TUMORS

2021 ◽  
pp. 58-60
Author(s):  
Manthan Patel ◽  
Naimish Patel
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Pituitary Tumors ◽  
Csf Leak ◽  
Total Removal ◽  
Diagnostic Investigation ◽  
Subtotal Removal ◽  
Visual Disturbances ◽  
Bitemporal Hemianopia

The study includes 25 cases of pituitary adenomas. Most common age group by pituitary tumors falls between 41-50 years of age. Male: Female incidence of these tumors is 1: 2.12. Most common clinical symptoms in our series are visual disturbances followed by headache. Optic nerve involvement is other common clinical nding presenting in form of decreased vision or loss of vision, eld defect or fundus changes. Commonest eld defect is bitemporal hemianopia. MRI is the diagnostic investigation of choice in pituitary tumors to dene extent, invasion and relationship to major vessels and nerves. Approximately half (44%) of the patients exhibited normal preoperative pituitary function in form of baseline hormone prole. Increased GH level (32%) followed by hyperprolactinemia (20%) are the most common endocrinologic abnormalities. Total/near total removal was done in 21 patients (84%) and subtotal removal done in 4 patients (16%). Adjuvant therapies were given in 5 patients. Two patients were given radiotherapy and 3 were given pharmacotherapy. Post operative complications were CSF leak, diabetes insipidus and meningitis. 20 patients (80%) had improvement in their symptoms including relief from headache, improvement in vision and endocrinal dysfunction. Post operatively visual functions improved in 13 patients (52%) and it remained stationary in 11 (44%) patients. Only one patient (4%) complained of worsening of his visual function and it was improved in follow up period

Introduction to the Six Eye Movement Systems and the Visual Fixation System

2008 ◽  
Author(s):  
Agnes Wong
Keyword(s):  
Visual Acuity ◽  
Eye Movements ◽  
High Resolution ◽  
Information Overload ◽  
Survival Rates ◽  
Large Field ◽  
Field Of Vision ◽  
Very High Spatial Resolution ◽  
Different Characteristics ◽  
The Brain

One main reason that we make eye movements is to solve a problem of information overload. A large field of vision allows an animal to survey the environment for food and to avoid predators, thus increasing its survival rate. Similarly, a high visual acuity also increases survival rates by allowing an animal to aim at a target more accurately, leading to higher killing rates and more food. However, there are simply not enough neurons in the brain to support a visual system that has high resolution over the entire field of vision. Faced with the competing evolutionary demands for high visual acuity and a large field of vision, an effective strategy is needed so that the brain will not be overwhelmed by a large amount of visual input. Some animals, such as rabbits, give up high resolution in favor of a larger field of vision (rabbits can see nearly 360°), whereas others, such as hawks, restrict their field of vision in return for a high visual acuity (hawks have vision as good as 20/2, about 10 times better than humans). In humans, rather than using one strategy over the other, the retina develops a very high spatial resolution in the center (i.e., the fovea), and a much lower resolution in the periphery. Although this “foveal compromise” strategy solves the problem of information overload, one result is that unless the image of an object of interest happens to fall on the fovea, the image is relegated to the low-resolution retinal periphery. The evolution of a mechanism to move the eyes is therefore necessary to complement this foveal compromise strategy by ensuring that an object of interest is maintained or brought to the fovea. To maintain the image of an object on the fovea, the vestibulo-ocular (VOR) and optokinetic systems generate eye movements to compensate for head motions. Likewise, the saccadic, smooth pursuit, and vergence systems generate eye movements to bring the image of an object of interest on the fovea. These different eye movements have different characteristics and involve different parts of the brain.

Retinal haemangioblastoma associated with peripheral non-perfusion: widefield fluorescein angiography analysis of 41 cases

2019 ◽  
Vol 104 (2) ◽  
pp. 167-172 ◽  
Author(s):  
Lauren A Dalvin ◽  
Michael D Yu ◽  
David Arturo Ancona-Lezama ◽  
Jose S Pulido ◽  
Timothy W Olsen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Basal Diameter ◽  
Younger Patients ◽  
Von Hippel Lindau ◽  
Patient Demographics ◽  
Time Period ◽  
Vhl Disease ◽  
Decrease In Visual Acuity

AimsTo investigate the association of peripheral retinal non-perfusion with retinal haemangioblastoma.MethodsMedical and widefield fluorescein angiography records of patients diagnosed with retinal haemangioblastoma from 1990 to 2018 were reviewed for patient demographics, tumour features, fluorescein angiography features and characteristics of peripheral retinal non-perfusion.ResultsThere were 41 eyes of 40 patients with retinal haemangioblastoma imaged by widefield fluorescein angiography during this time period. Of 41 eyes, 14 (34%) had haemangioblastoma-associated peripheral retinal non-perfusion on fluorescein angiography. A comparison of eyes with versus without non-perfusion revealed younger mean age at presentation (28 vs 43 years old, p=0.05), increased prevalence of von Hippel-Lindau (VHL) disease (62% vs 22%, p=0.01), greater mean largest tumour basal diameter (3.7 vs 2.5 mm, p=0.04), greater tumour distance from optic nerve (8.4 vs 1.9 mm, p<0.01) and increased prevalence of vascular leakage from the tumour (86% vs 52%, p=0.03). After mean follow-up of 97 versus 71 months (p=0.52), eyes with non-perfusion were significantly more likely to develop neovascularisation (40% vs 0%, p<0.01) and experience a three-line or greater decrease in visual acuity (60% vs 11%, p<0.01).ConclusionPeripheral retinal non-perfusion can be associated with retinal haemangioblastoma, and could be more common with larger, more peripheral tumours in younger patients with VHL disease. Eyes with haemangioblastoma-associated peripheral non-perfusion could be more likely to develop neovascularisation and lose visual acuity.

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