FP648 : Bilateral Optic atrophy- The only presenting manifestation of an underlying pituitary adenoma

 

Dr.SHRUTHI K, S21116

Introduction:Pituitary adenoma is a common cause of Optic chiasm compression presenting with Visual field defects, Ocular motility deficits & Optic atrophy.

Case report:A 56yr old patient presented to OPD seeking visual deficit certificate with h/o total vision loss in RE and partial vision loss in LE since 3yrs. On evaluation,BCVA in RE–NO PL, LE- 6/18, RAPD+ in RE. Fundoscopy-RE primary optic atrophy, LE-disc-C:D 0.5to0.6 with temporal pallor. IOP BE-13mm Hg. Gonioscopy- open angles in BE. HFA 30-2 LE -Temporal hemianopia that led to the suspicion of a neurological cause. CT brain: a well defined lesion in sella with optic chiasmal compression–s/o PITUTARY MACROADENOMA.

Conclusion:Most common feature of pituitary adenoma is endocrine dysfunction,visual field defects occurs at a later stage. However here vision loss occured as presenting feature . A high index of suspicion and thorough evaluation for a neurological cause is mandatory in such cases.