Presentation on theme: "Grand Rounds Conference"— Presentation transcript:
1Grand Rounds Conference Eric Downing MDUniversity of LouisvilleDepartment of Ophthalmology and Visual Sciences2/20/15
2SubjectiveCC/HPI: 35 year old male with complaint of progressive decreased peripheral vision x 6 months. No flashes/floaters or blurry vision.Review of Systems: denies dizziness, weakness, numbness, or headaches.Ptosis – progressive over several years, OD > OS. Holds lids up to see.
16Treatment Observation Medical: Bromocryptine for prolactinomas Surgery RadiotherapySjogren and Hashimoto thyroiditis; HIV
17Associated Syndromes Multiple Endocrine Neoplasia Type 1 Pituitary Adenomas (prolactinomas)ParathyroidPancreatic Islet cell tumorPituitary ApoplexyInfarction of a pituitary tumor or sudden hemorrhage withinSudden onset of HA, vision loss, diplopia, and/or ptosis
18ResearchInvestigated the degree of residual VF impairment with size of adenomaRetrospective analysisDivided groups based on vertical tumor sizeCreated a Visual Impairment Score (VIS)VA and VF defect parametersResults: tumors greater than 20mm result in persistent vision deficits, and should undergo surgical resection
19References BCSC: Neuro-Ophthlamology. Pgs 146-151 Pituitary Tumors: adenoma, craniopharyngioma, cysts. Mayfield Clinic and Spine Institute. Feb pgs 1-6Ferrante E, Ferraroni M, Castrignano T, Menicatti L, Anagni M, Reimondo G, et al. Non-functioning pituitary adenoma database: a useful resource to improve clinical management of pituitary adenomas. Eur J Endocrinol 155: , 2006.The influence of pituitary adenoma size on vision and visual outcomes after trans-sphenoidal adenectomy: a report of 78 cases. Ren-Wan H, Hsiu-Mei H, Jih-Tsun H. J Korean Neurosug Soc 57(1): 23-31, 2015