[Neuro-ophthalmological manifestations of pituitary adenomas. The usefulness of optical coherence tomography]. / Manifestaciones neurooftalmológicas de los adenomas hipofisarios. Valor de la tomografía de coherencia óptica.

INTRODUCTION: Pituitary adenomas are a frequently occurring pathology that require multidisciplinary management by several different specialists. Their neuro-ophthalmological manifestations vary widely and sometimes appear as the presenting symptom. AIM: To gather the main ophthalmological signs and symptoms of these tumours so that specialists who find themselves before any of them will suspect this pathology. DEVELOPMENT: This survey was based on the clinical experience of the neuro-ophthalmological unit at the Hospital Clinic de Barcelona, with over 350 patients who had suffered from pituitary tumours. A bibliographical search was also carried out on Medline for papers published on pituitary adenomas in the literature in both English and Spanish. We focused mainly on those that reported on the ophthalmological manifestations of such tumours. A number of articles were found dealing with isolated ophthalmological manifestations of these tumours, many of them as presenting symptoms. We also found review articles in English. Apart from oculomotor disorders and other less common findings, visual field defects stand out as the guiding symptom of this condition. CONCLUSIONS: Improved diagnostic techniques are allowing pituitary tumours to be detected at increasingly earlier stages, but cases are still seen with neuro-ophthalmological symptoms as the presenting symptoms. Familiarity with these syndromes is crucial. In addition to the clinical and visual field examination, optical coherence tomography is particularly useful for the diagnosis and follow-up of these patients. Prospective studies are needed to establish factors for predicting the visual recovery in these patients.

Manifestaciones neurooftalmológicas de los adenomas hipofisarios. Valor de la tomografía de coherencia óptica / Neuro-ophthalmological manifestations of pituitary adenomas. The usefulness of optical coherence tomography

Introducción. Los adenomas hipofisarios son una patología frecuente. Requieren un tratamiento multidisciplinario entre varios especialistas. Sus manifestaciones neurooftalmológicas son muy variadas, y en ocasiones aparecen como síntoma de presentación. Objetivo. Reunir los principales signos y síntomas oftalmológicos de estos tumores, para que todo especialista sospeche esta patología cuando se encuentre ante alguno de ellos. Desarrollo. Esta revisión se ha desarrollado sobre la base de la experiencia clínica de la unidad de neurooftalmología del Hospital Clínic de Barcelona, con más de 350 pacientes afectos de tumores hipofisarios. Asimismo, se ha realizado una búsqueda bibliográfica en Medline de los artículos publicadossobre adenomas hipofisarios en lengua castellana e inglesa. Se centró principalmente en aquéllos que se referían a las manifestaciones oftalmológicas de dichos tumores. Se encontraron numerosos artículos referentes a manifestaciones oftalmológicas aisladas de estos tumores, muchas de ellas como inicio. También se encontraron artículos de revisión en lengua inglesa.Aparte de las alteraciones oculomotoras y otros hallazgos menos frecuentes, destacan las alteraciones campimétricas como síntoma guía de esta patología. Conclusiones. Los tumores hipofisarios se detectan cada vez más temprano debido a la mejora en las técnicas diagnósticas, pero aún se observan casos con síntomas neurooftalmológicos como inicio. Resulta crucialel conocimiento de estos síndromes. Además de la exploración clínica y la campimetría, la tomografía de coherencia óptica resulta de gran valor para el diagnóstico y el seguimiento de estos pacientes. Se necesitan estudios prospectivos para establecerfactores pronósticos de recuperación visual en estos pacientes

Introduction. Pituitary adenomas are a frequently occurring pathology that require multidisciplinary management by several different specialists. Their neuro-ophthalmological manifestations vary widely and sometimes appear as the presenting symptom. Aim. To gather the main ophthalmological signs and symptoms of these tumours so that specialists who find themselves before any of them will suspect this pathology. Development. This survey was based on the clinical experience of the neuro-ophthalmological unit at the Hospital Clínic de Barcelona, with over 350 patients who had suffered from pituitary tumours. A bibliographical search was also carried out on Medline for papers published on pituitary adenomas in the literature in both English and Spanish. We focused mainly on those that reported on the ophthalmological manifestations ofsuch tumours. A number of articles were found dealing with isolated ophthalmological manifestations of these tumours, many of them as presenting symptoms. We also found review articles in English. Apart from oculomotor disorders and other less common findings, visual field defects stand out as the guiding symptom of this condition. Conclusions. Improved diagnostictechniques are allowing pituitary tumours to be detected at increasingly earlier stages, but cases are still seen with neuroophthalmological symptoms as the presenting symptoms. Familiarity with these syndromes is crucial. In addition to the clinical and visual field examination, optical coherence tomography is particularly useful for the diagnosis and follow-up ofthese patients. Prospective studies are needed to establish factors for predicting the visual recovery in these patients