Ann Optom Contact Lens.  2024 Jun;23(2):85-90. 10.52725/aocl.2024.23.2.85.

A Case of Pituitary Rathke’s Cleft Cyst Associated with Decreased Visual Acuity after Cataract Surgery

• Kim MS
• Yoon YC
• Park SK
• Whang WJ
• Hwang HS
• Kim HS
• Na KS
• Park M

• KMID: 2556630
• DOI: http://doi.org/10.52725/aocl.2024.23.2.85

Abstract

Purpose
To report a case of suprasellar Rathke's cleft cyst accompanying visual field defect found in a patient complaining of decreased visual acuity after cataract surgery.
Case Summary
A 62-year-old male patient who showed a best-corrected visual acuity (BCVA) of 0.6 after left eye cataract surgery visited our hospital two months after surgery with decreased vision. He showed a best corrected visual acuity of 0.2, did not have relative afferent pupillary defect, and there were no specific findings on fundus examination. In the full field perimetry test, partial visual field loss in superior temporal quadrants were found in both eyes, being more prominent in left eye. In ganglion cell layer measurements using optical coherence tomography, a symmetric thinning in the thickness of the nasal ganglion cell layer was observed in both eyes, which was consistent with the visual field test. It was discovered that a liquid solid mass with a diameter of 21 mm in the upper part of the pituitary gland was compressing the optic chiasm in orbit magnetic resonance imaging. The patient was then referred to neurosurgery for pituitary surgery using transsphenoidal approach and diagnosed with Rathke's cleft cyst on histopathologic examination. Three months after surgery, the BCVA has increased to 0.5 and the visual field test showed no scotoma.
Conclusions
We report a case that Rathke's cleft cyst above the sella turcica inducing visual disturbances, emphasizing the importance of early detection and treatment through neuroophthalmological evaluation in a patient presenting with unexplained visual impairment.

Keyword

Central nervous system cysts; Optic chiasm; Pituitary neoplasms; Vision disorders