Dorotheo E Ulysses, Tang Rosa A, Bahrani Hasan M, Schiffman Jade S, Bhatti M Tariq, Lewis Stephen B
University of Texas Medical Branch, Galveston, Texas, USA.
Surv Ophthalmol. 2005 Nov-Dec;50(6):588-97. doi: 10.1016/j.survophthal.2005.09.001.
A 50-year-old female presented with progressive painless vision loss in the left eye and was subsequently diagnosed to have a pituitary macroadenoma, consistent with a prolactinoma, which was compressing the chiasm primarily on the left and involving the left cavernous sinus. She was treated with oral bromocriptine, resulting in marked shrinkage of the tumor and significant visual field recovery. Subsequently, she again began noting progressive vision loss in both eyes and was initially thought to have pituitary tumor regrowth. Repeat brain MRI, however, showed chiasmal prolapse with inferior tethering into an empty sella. Surgical fat padding to reposition the chiasm resulted in visual improvement with a different visual field pattern in the left eye. The clinical manifestations and etiopathogenesis of the empty sella syndrome are discussed.
一名50岁女性因左眼渐进性无痛视力丧失就诊，随后被诊断为垂体大腺瘤，符合催乳素瘤，主要压迫左侧视交叉并累及左侧海绵窦。她接受了口服溴隐亭治疗，肿瘤明显缩小，视野显著恢复。随后，她再次开始注意到双眼渐进性视力丧失，最初被认为是垂体肿瘤复发。然而，重复脑部MRI显示视交叉下垂并向下束缚至空蝶鞍。手术填充脂肪以重新定位视交叉，使左眼视野模式不同，视力得到改善。本文讨论了空蝶鞍综合征的临床表现和发病机制。
