C4.010 - Compressive Optic Neuropathy

Case not moderated.

59 year old lady came for blurring of vision right eye since 6 months. She was a known diabetic for 4 years, hypertensive for 3 years and hypothyroid for 3 yrs. On examination, her BCVA right eye 3/60, left eye 6/9. Color vision was subnormal in the left eye. There was a RAPD in the right eye. Both eyes had moderate cataract.

Color Fundus Photo

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RE 0.5 CD ratio diffuse disc pallor

Color Fundus Photo

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LE temporal pallor 0.8 CD ratio

Visual Fields

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Bitemporal hemianopia

Visual Fields

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Bitemporal hemianopia

ONH and RNFL analysis

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both eyes-average values decreased, Right eye –superior and inferior thinning, Left eye - temporal thinning

MRI

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MRI Brain with contrast-- Sellar mass with cystic areas 38/27/37 mmin size with suprasellar extension, abutting the optic chiasm and encasing left cavernous Internal Carotid Artery - Pituitary macroadenoma with necrosis

MRI

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MRI

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