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Homonymous hemianopsia due to optic tract disorder with prolactin producing pituitary adenoma Yuka Kikuchi 1 , Morihiko Sano 1 , Hideo Akiyama 2 1Department of Ophthalmology, SUBARU Health Insurance Society Ota Memorial Hospital 2Department of Ophthalmology, Gunma University School of Medicine pp.475-480
Published Date 2022/4/15
DOI https://doi.org/10.11477/mf.1410214350
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Abstract Purpose:We report a case of prolactin-producing pituitary adenoma that presented as homonymous hemianopsia due to the optic tract disorder.

Case:A 79 year-old male with decreased cognitive function, in whom pituitary adenoma suspected in head MRI was referred to neurosurgery at our hospital. The best-corrected visual acuity was 0.5 in the right eye and 0.7 in the left eye. The color of the optic disc of the right eye was moderately pale, but the light reflex was normal. No abnormalities were seen in the optic disc of the left eye, but relative afferent pupillary defect was positive. Left homonymous hemianopsia was diagnosed. A thinning area was seen in ganglion cell analysis with optical coherence tomography according to the visual field defect. Head contrast-enhanced MRI showed an irregular mass with the cystography effect. It extended from the sella turcica to the right side of the suprasellar region and extended backward invading the right cavernous sinus, optic chiasm, it included a giant cyst with bleeding from the right basal ganglia to the frontal lobe. The prolactin(PRL)level in the blood was 16,610.10 ng/ml, and he was diagnosed with PRL-producing pituitary adenoma. He has been followed up with bromocriptine intake.

Discussion:Visual field abnormality due to the pituitary adenoma is often presented as a temporal visual field defect such as the temporal hemianopia. However, depending on the type of tumor extension, it may compress the optic tract and present as homonymous hemianopsia.


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