Her Vision Was Tied Down

E. Ulysses Dorotheo, Rosa A. Tang, Hasan M. Bahrani, Jade S. Schiffman, M. Tariq Bhatti, Stephen B. Lewis

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

A 50-year-old female presented with progressive painless vision loss in the left eye and was subsequently diagnosed to have a pituitary macroadenoma, consistent with a prolactinoma, which was compressing the chiasm primarily on the left and involving the left cavernous sinus. She was treated with oral bromocriptine, resulting in marked shrinkage of the tumor and significant visual field recovery. Subsequently, she again began noting progressive vision loss in both eyes and was initially thought to have pituitary tumor regrowth. Repeat brain MRI, however, showed chiasmal prolapse with inferior tethering into an empty sella. Surgical fat padding to reposition the chiasm resulted in visual improvement with a different visual field pattern in the left eye. The clinical manifestations and etiopathogenesis of the empty sella syndrome are discussed.

Original languageEnglish (US)
Pages (from-to)588-597
Number of pages10
JournalSurvey of Ophthalmology
Volume50
Issue number6
DOIs
StatePublished - Jan 1 2005

Keywords

  • bromocriptine
  • chiasmal prolapse
  • chiasmopexy
  • empty sella
  • prolactinoma

ASJC Scopus subject areas

  • Ophthalmology

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