Optical Coherence Tomography Abnormalities as the Presenting Sign of an Involuted Sellar/Suprasellar Mass
Introduction: Pituitary adenomas are benign tumours that can lead to visual loss through compression of the optic chiasm. Patients with pituitary adenomas often present with visual field defects (commonly bitemporal hemianopia), but some may be asymptomatic. In such cases, abnormalities may only be...
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Karger Publishers
2024-10-01
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| Series: | Case Reports in Ophthalmology |
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| author | Arshia Vosoughi Jonathan A. Micieli |
| author_facet | Arshia Vosoughi Jonathan A. Micieli |
| author_sort | Arshia Vosoughi |
| collection | DOAJ |
| description | Introduction: Pituitary adenomas are benign tumours that can lead to visual loss through compression of the optic chiasm. Patients with pituitary adenomas often present with visual field defects (commonly bitemporal hemianopia), but some may be asymptomatic. In such cases, abnormalities may only be detected through visual field testing or optical coherence tomography (OCT) of the ganglion cell-inner plexiform layer (GCIPL), which may provide a more sensitive method for detecting such abnormalities. Case Presentation: A 72-year-old man was incidentally found to have binasal OCT-GCIPL thinning during a routine eye examination. Visual acuity was 20/20 in both eyes. Pupils were equal and reactive without a relative afferent pupillary defect. His Humphrey 24-2 SITA-Fast visual field test results were normal. A magnetic resonance imaging (MRI) revealed a nonenhancing (cystic) sellar/suprasellar mass measuring 1.7 cm craniocaudal by 2.1 cm anteroposteriorly, without associated optic chiasm compression. The lesion was suspected to be either a cystic pituitary adenoma or a Rathke’s cleft cyst. Follow-up examination 1 year later showed all findings remained stable, including an unchanged visual acuity, visual fields, OCT-GCIPL, and MRI. Conclusion: The binasal thinning observed on OCT-GCIPL in this case, despite the absence of chiasmal compression on MRI, is suggestive of previous compression of the optic chiasm. This case highlights the potential for spontaneous regression of pituitary adenomas and underscores the importance of OCT-GCIPL as a vital tool for detecting optic chiasmal damage. |
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| institution | Kabale University |
| issn | 1663-2699 |
| language | English |
| publishDate | 2024-10-01 |
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| series | Case Reports in Ophthalmology |
| spelling | doaj-art-749de482f920485984061bb80545148b2024-11-14T07:28:50ZengKarger PublishersCase Reports in Ophthalmology1663-26992024-10-0115175776110.1159/000541680541680Optical Coherence Tomography Abnormalities as the Presenting Sign of an Involuted Sellar/Suprasellar MassArshia Vosoughi0Jonathan A. Micieli1University of Toronto, Toronto, ON, CanadaDepartment of Ophthalmology and Vision Sciences, Department of Medicine, University of Toronto, Toronto, ON, CanadaIntroduction: Pituitary adenomas are benign tumours that can lead to visual loss through compression of the optic chiasm. Patients with pituitary adenomas often present with visual field defects (commonly bitemporal hemianopia), but some may be asymptomatic. In such cases, abnormalities may only be detected through visual field testing or optical coherence tomography (OCT) of the ganglion cell-inner plexiform layer (GCIPL), which may provide a more sensitive method for detecting such abnormalities. Case Presentation: A 72-year-old man was incidentally found to have binasal OCT-GCIPL thinning during a routine eye examination. Visual acuity was 20/20 in both eyes. Pupils were equal and reactive without a relative afferent pupillary defect. His Humphrey 24-2 SITA-Fast visual field test results were normal. A magnetic resonance imaging (MRI) revealed a nonenhancing (cystic) sellar/suprasellar mass measuring 1.7 cm craniocaudal by 2.1 cm anteroposteriorly, without associated optic chiasm compression. The lesion was suspected to be either a cystic pituitary adenoma or a Rathke’s cleft cyst. Follow-up examination 1 year later showed all findings remained stable, including an unchanged visual acuity, visual fields, OCT-GCIPL, and MRI. Conclusion: The binasal thinning observed on OCT-GCIPL in this case, despite the absence of chiasmal compression on MRI, is suggestive of previous compression of the optic chiasm. This case highlights the potential for spontaneous regression of pituitary adenomas and underscores the importance of OCT-GCIPL as a vital tool for detecting optic chiasmal damage.https://beta.karger.com/Article/FullText/541680optical coherence tomographysellar masssuprasellar masscase reportophthalmology |
| spellingShingle | Arshia Vosoughi Jonathan A. Micieli Optical Coherence Tomography Abnormalities as the Presenting Sign of an Involuted Sellar/Suprasellar Mass Case Reports in Ophthalmology optical coherence tomography sellar mass suprasellar mass case report ophthalmology |
| title | Optical Coherence Tomography Abnormalities as the Presenting Sign of an Involuted Sellar/Suprasellar Mass |
| title_full | Optical Coherence Tomography Abnormalities as the Presenting Sign of an Involuted Sellar/Suprasellar Mass |
| title_fullStr | Optical Coherence Tomography Abnormalities as the Presenting Sign of an Involuted Sellar/Suprasellar Mass |
| title_full_unstemmed | Optical Coherence Tomography Abnormalities as the Presenting Sign of an Involuted Sellar/Suprasellar Mass |
| title_short | Optical Coherence Tomography Abnormalities as the Presenting Sign of an Involuted Sellar/Suprasellar Mass |
| title_sort | optical coherence tomography abnormalities as the presenting sign of an involuted sellar suprasellar mass |
| topic | optical coherence tomography sellar mass suprasellar mass case report ophthalmology |
| url | https://beta.karger.com/Article/FullText/541680 |
| work_keys_str_mv | AT arshiavosoughi opticalcoherencetomographyabnormalitiesasthepresentingsignofaninvolutedsellarsuprasellarmass AT jonathanamicieli opticalcoherencetomographyabnormalitiesasthepresentingsignofaninvolutedsellarsuprasellarmass |