J Korean Ophthalmol Soc.  2009 Sep;50(9):1437-1441. 10.3341/jkos.2009.50.9.1437.

A Case of Complete Visual Recovery From No Light Perception After Resection of Pituitary Adenoma

• Kim SH
• Suk KW
• Lee JE

• KMID: 2212632
• DOI: http://doi.org/10.3341/jkos.2009.50.9.1437

Abstract

PURPOSE
We report a case of a patient with no preoperative light perception who achieved complete visual recovery after transsphenoidal resection of a pituitary adenoma. CASE SUMMARY: A 53-year-old man with a history of pituitary adenomectomy visited our clinic complaining of decreased vision of 7 weeks ducation. His best-corrected visual acuity was 1.2 in his right eye, and he had no light perception (NLP) in his left eye. Light reflex was absent in the left eye, and no consistent wave was detected in the left eye on flash visual evoked potential (FVEP). A pituitary adenoma 3x3.5 cm in diameter was found following magnetic resonance imaging (MRI), and was removed using a transsphenoidal approach and gamma knife radiosurgery. Six weeks postoperatively, his best corrected visual acuity improved to 1.0 in the left eye. CONCLUSIONS: Prompt management should be initiated in patients with no light perception vision, due to compressive optic neuropathy.

Keyword

Blindness; Pituitary adenoma; Recovery vision

MeSH Terms

Blindness
Evoked Potentials, Visual
Eye
Humans
Light
Magnetic Resonance Imaging
Middle Aged
Optic Nerve Diseases
Pituitary Neoplasms
Radiosurgery
Reflex
Vision, Ocular
Visual Acuity

Figure

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  Figure 1. Preoperative fundus photographs show a relatively pale optic disc in the left eye.

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  Figure 2. Preoperative flash visual evoked potential (FVEP) of the right (A) and the left eye (B). No consistent wave is detected in the left eye compared with normal latency seen in the right eye.

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  Figure 3. Humphrey visual field test of the right eye (A) preoperatively and the left (B) and the right eye (C) 6 weeks after transsphenoidal pituitary adenoma resection. Postoperatively, generalized reduction in the sensitivity and constricted visual field is found in the left eye.

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  Figure 4. Preoperative coronal (A) and sagittal (B) enhanced T1-weighted MR image showed peripheral enhancing sellar and suprasellar mass markedly compressing the optic chiasm (arrow). Postoperative coronal (C) and sagittal (D) enhanced T1-weighted MR image showed decreased degree of optic chiasm compression by the partial tumor resection.

Reference

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