VISUAL FIELD DEFECTS; THE  COMPARISON  BEFORE  AND  AFTER  EXCISION  OF  SELLA  SUPRA  SELLAR   TUMORS BY PERFORMING THE PRE AND POST-OP COMPUTERIZED PERIMETRY

Objectives: To obtain and compare the exact visual status before and afterexcision of sella supra sellar tumors using the computerized perimetry as a standard measuringtools and then compare with the international studies. Background: Sella suprasellar tumorsare though not so common but affect visual acuity of patients and their quality of life drops.These tumors include pituitary adenoma commonest in the adult population, meningioma,Craniopharyngioma, astrocytic glioma, Optic nerve Glioma, Germinoma, Dermoid, Pituitarymetastases. We planned a descriptive case series study to compare the pre and post excisionvisual field defects using computerized perimetry. Study Design: Case series study. Setting:Department of Neurosurgery, Pakistan Institute of Medical Sciences, SZABMU, and Islamabad.Period: 2 years from January 2015 to December 2016. Methods: A total of 73 patients withsella suprasellar tumors were identified and enrolled. Patients between the age of 10 and55 years were selected on the basis of having sella supra sellar tumor on CT/MRI brain withcontrast. Patients whose age was less than 10 years and more than 55 years were excluded.Moreover, patients with post radiation necrosis diagnosed on MRI and MR spectroscopy brain,those operated for other eye pathology and patients with sella supra sellar SOL having comorbiditieslike diabetes mellitus, hypertension etc. were also excluded from the study. Thestudy outcome was measured in terms of comparison of visual field defects after excision ofsella suprasellar tumors using computerized perimetry. Results: The average age of patientswas 42.1 + 6.8 years ranging from 10 to 55 years. Female gender was predominant; therewere 40 (54.8%) female patients. The mean computerized perimetry was 0.65 + 0.34 LogMARbefore surgery which improved to 0.19 + 0.12 LogMAR after surgery. Overall, of the 73 cases,63 (86.4%) had improvement whereas 10 (13.6%) study cases had no improvement in thevisual field on follow-up. Conclusion: It can be concluded that after craniotomy and excisionof sella suprasellar tumors, perimetry showed improvement in the majority of the study cases.

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Normal visual fields as assessed by computerized static threshold perimetry in patients with untreated primary hypothyroidism

Acta Endocrinologica ◽

10.1530/acta.0.1210495 ◽

1989 ◽

Vol 121 (4) ◽

pp. 495-500 ◽

Cited By ~ 1

Author(s):

Bengt Hallengren ◽

Per Manhem ◽

Margareta Bramnert ◽

Inga Redlund-Johnell ◽

Anders Heijl

Keyword(s):

Visual Field ◽

Prospective Study ◽

Visual Fields ◽

Primary Hypothyroidism ◽

Common Finding ◽

Visual Field Defects ◽

Computer Assisted ◽

Computerized Perimetry ◽

Assisted Analysis ◽

Field Defects

Abstract. In this prospective study, 25 consecutive patients with untreated primary hypothyroidism were tested with a highly sensitive perimetric technique, since a high prevalence of visual field defects has been described in this condition. All patients had clinical hypothyroidism, a serum TSH value > 20 mU/l (reference range 0.4–4.0) and decreased/low normal serum total T4 concentration. Visual fields were tested with fully automated threshold-measuring computerized perimetry of the central 30 degrees field. Interpretation of fields included computer-assisted analysis provided by a perimetric statistical programme package. In 23 patients, conventional inspection and computer-assisted analysis showed no visual field defects. Two patients were excluded from the latter analysis: one patient who did not respond adequately at computerized perimetry and in whom manual field tests were entirely normal; one patient who had low sensitivity values in the uppermost parts of both visual fields owing to markedly swollen upper eye lids. In conclusion, although pituitary hyperplasia has been well documented in primary hypothyroidism, the present prospective study clearly indicates that visual field defects are not a common finding in patients with this disease.

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