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Pituitary macroadenoma misdiagnosed as advanced normal tension glaucoma
Author(s) -
POPA CHERECHEANU A,
COMAN CI,
IANCU R,
PARVULESCU RA,
STANA D,
DASCALU AM
Publication year - 2013
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2013.t035.x
Subject(s) - medicine , glaucoma , visual field , hemianopsia , visual acuity , pituitary adenoma , ophthalmology , optic chiasm , fundus (uterus) , normal tension glaucoma , surgery , optic nerve , adenoma , pathology , open angle glaucoma
Purpose To present the clinical case of a patient with a giant pituitary adenoma that was misdiagnosed for several years and treated as a progressive NTG (Normal Tension Glaucoma). Methods A 57 years old male had his first ocular examination in December 2008 and was diagnosed with NTG and started on topical treatment. The patient was declared unable to perform automated perimetry, so he was referred for Goldmann perimetry. He had several ocular exams over a period of four years, during which the treatment was gradually increased to maximal topical therapy, but the patient still developed a progressive impairment of the visual acuity, visual field and fundus aspect. Results The patient was referred to our clinic in August 2012 for surgical management of his bilateral severe progressive glaucoma. During the hospital admittance, we performed automated perimetry that showed hemianopsia; he was referred afterwards for cerebral MRI and diagnosed with giant extensive pituitary adenoma. The patient had surgery, but he continued to lose visual acuity and optic atrophy installed at both eyes. Conclusion NTG should remain an exclusion diagnosis (after excluding a chiasm compression as well).