Criteria for early detection of temporal hemianopia in asymptomatic pituitary tumor.

PURPOSE

To determine new criteria for early detection of temporal hemianopia in patients with asymptomatic pituitary tumor.

METHODS

Fifteen patients without visual symptoms had pituitary tumor and subtle defects or normal visual fields by Goldmann perimetry. Twelve patients with visual symptoms had pituitary adenoma and visual field defects detected by Goldmann perimetry. All were examined by automated perimetry. The relationship between the tumor and the optic chiasm was graded by magnetic resonance imaging (MRI) on a scale of 0-4. Grade number increased with extent of compression. Temporal hemianopia observed by automated perimetry was estimated from normal data (52 normal fields). Vertical step was determined from the number of adjacent pairs along the midline; sensitivity was lower in the temporal field than in the nasal field. Temporal depression was calculated by the quadrant sum of sensitivity.

RESULTS

All patients with symptomatic pituitary adenoma had vertical step and temporal depression in the upper field. Nine of 15 patients without visual symptoms had vertical step or temporal depression. Of nine patients with temporal hemianopia, two of four patients had grade 1 compression, three of five had grade 2, and four of four had grade 3.

CONCLUSIONS

New criteria by automated perimetry could detect temporal hemianopia in patients with asymptomatic pituitary tumor.