J Med Assoc Thai 2008; 91 (5):711

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Ocular Manifestations of Suprasellar Tumors
Kitthaweesin K Mail, Ployprasith C

Objective: To determine ocular manifestations of suprasellar tumors and to identify the pre-operative factors
that might influence final visual outcomes.

Material and Method: Medical records of 69 patients with a diagnosis of suprasellar tumor at Srinagarind
Hospital between January 1995 and December 2005 were retrospectively reviewed.

Results: The present study focused on 69 patients (39% men and 61% women) with averaged 37.74 years of
age (range, 6 to 75). The duration of symptoms was between 4 days and 5 years (average, 7.7 months). The
ocular manifestations included visual loss in 59 (86%), eye pain in six (9%), diplopia in three (4%), and
ptosis in one (1%) patient. The respective definite diagnosis were pituitary adenoma, suprasellar meningioma,
and craniopharyngioma in 33 (48%), 19 (28%), and 17 (25%) patients. According to the pre-operative visual
acuity in the worse eye, seven (10%), seven (10%), and 55 (80%) patients were stratified to Group I (VA 6/5
to 6/12), Group II (VA 6/18 to 6/36), and Group III (VA 6/60 to no vision), respectively. Post-operatively, two
(29%) patients in Group II and 14 (25%) in Group III had improved visual acuity. Three groups of visual field
defect were revealed, viz., Group A (normal visual field), Group B (typical field defect) and Group C (atypical
field defect) in seven (10%), 49 (71%), and 13 (19%) patients, respectively. Positive relative afferent pupillary
defect was detected in 31 patients (45%) and optic disc atrophy was detected in 26 patients (38%).

Conclusion: Pituitary adenoma was the most frequent suprasellar tumor and visual loss was the most common
ocular presentation. Bitemporal hemianopia frequently occurred in these patients, but was usually asymmetrical
and unpredictable in its evolution.

Keywords: Craniopharyngioma, Meningioma, Ocular manifestation, Pituitary tumor, Suprasellar tumor

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