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概要

Intermittent Colour Vision Changes Secondary to Pituitary Macroadenoma

Bogna M Zborowska

Pituitary adenomas are the most common benign tumours of the sellar region. They represent 10%-15% of all intracranial neoplasms. Macroadenomas are tumours exceeding 10 mm in diameter. They carry a significant morbidity and sometimes mortality risk if not treated in a timely manner, usually by surgical extirpation. Manifestations of tumours that arise from a pituitary gland are diverse. Patients with macroadenomas may be asymptomatic or may present with hormonal imbalance or mass effects. Hormone secreting tumours can give rise to hyperthyroidism, Cushing syndrome or hyperprolactinemia. The mass effect can manifest as headaches, visual deficits, or sudden intracranial haemorrhage. Visual deficits result from chiasmal compression that leads to bitemporal hemianopia or complete vision loss from optic nerve compression. Pituitary apoplexy, which results from infarction or intra-pituitary haemorrhage is a medical emergency, which can lead to a sudden onset of headache, collapse, shock and death. Significant morbidity is also associated with treatment of these tumours. The case below illustrates how intermittent colour vision changes can lead to detection of optic chiasmal compression by a pituitary macroadenoma and how they resolve after the surgery.