incidence and significance of optic atrophy in cases of pituitary tumours

ABSTRACT

A study was made on 18 cases with pituitary tumors to ascertain the incidence and significance of optic atrophy. Disc pallor was seen in 13 cases [22 eyes]. It was usually bilateral, but with a distinct difference between the sides. Disc pallor was commonly of the diffuse type [12 eyes]. Temporal pallor was seen in six eyes and in four eyes pallor was associated with atrophic excavation of and optic disc. In five cases ophthalmoscopic examination revealed no changes at the optic disc in spite of visual and field defects. Examination of the retinal fibers by red-free light in these five cases showed atrophy of the retinal fiber layer. Fluorescein anagiography showed signs of optic atrophy before ophthalmoscopic examination in three cases. Disc pallor was present even where the subjective duration of visual symptoms was as short as six months and it became increasingly frequent the longer the history. The optic atrophy usually lagged behind the loss of vision and the degree of disc damage was related to the degree of visual loss and to a less extent to the degree of field defect. The presence of optic atrophy did not preclude the possibility of rapid and full recovery of vision after extirpation of pituitary tumor. The outlook for recovery of visual function was generally good if pallor was not combined with atrophic excavation of the optic disc