VF Loss Flashcards
Pituitary adenoma
Pituitary sits in sella turcica close to chiasm, the location of the decussation of the nasal fibers of the optic nerve fibers. Lesion at the chiasm results in bitemporal hemianopsia, respecting vertical midline in both eyes
-may be hormone secreting (functional) or nonfunctional
Most common functional pituitary macroadenoma
Prolactin secreting tumor
- amenorrhea
- galactorhra
ONH and chiasmal lesions
May or may not cause abnormal ONH appearances
-bow tie atrophy or papiledema
Parrietal lobe lesion
Homonymous inferior quadrantanopia (pie on the floor) due to compression of superior optic radiation
Temporal lobe lesion
Homonymous superior quadrantanopsia (pie in the sky) d/t compression of the inferior optic radiation
PITS
Parietal inferior
Temporal superior
Glaucoma VF defects
Correspond to the anatomy of the RNFL, may be unilateral or bilateral and asymmetric, and will respect the vertical midline; possible defects include arcuate scotomas, nasal steps, and/or Bjerrum scotomas
toxic optic neuropathy VF defect
Central or cecocentral defect
Occipital lobe lesion VF defect
Homonymous, congruous defect that respects the vertical midline (may be complete or incomplete)
Tilted disc VF defect
Pseudo-bitemproal; hemianopsia that does NOT respect the vertical midline; occurs in patients who are highly myopic with juxtapapillary atrophy and possible optic nerve hypoplasia
Foster Kennedy syndrome
Optic disc edema in one eye and optic dis atrophy in the other eye. It is due to a tumor in the frontal lobe. The VF is often initally normal in the eye with the optic disc edema central field loss is often noted in the eye with optic atrophy
What kind of lesions can have a homonymous VF defect
Post chiasmal only
CVA VF defect
Macualr sparing homonymous VF defect, as only one blood supply will be affected. This type of VF defect does not raise concerns for a compressive lesion as is the case wit ha macula only homonymous VF defect
Treatment forpituitary adenomas what cause hyperporlactinemia
Bromocroptine (also treats Parkinson’s I think)
Junctional scotoma
Chiasmal lesion that compresses the adjacent optic nerve, resulting in a temporal VF defect in one eye that respects the vertical midline, and a central or diffuse VF defect in the fellow eye with optic nerve compression. The eye with optic nerve compression will also have decreased vision
