A Case Series of Variations in Visual Field Defects in Chiasmal Syndrome: Insight from Sellar Tumor-Associated Cases

Abstract

Introduction: Visual field examination is important in evaluating patients with visual loss, intended to assess defects and locate lesions that occur along afferent visual pathways. The optic chiasm is an important structure in Neuro-ophthalmology because of the arrangement of visual pathways and visual field defects caused by various pathological conditions such as compression, inflammation, demyelination, ischemia, and infiltration. This case series aimed to report the variation of visual field defects that can occur in patients with chiasmal syndrome.

Case Report: First cases, 54 years 54-year-old male presenting with blurry vision in both eyes for two months before, there were missing letters when reading. Presenting Humphrey Visual Field (HVF) 30-2 examination shows bitemporal hemianopia. Second case, 49 years 49-year-old female presenting with vision loss in the left eye for three months before with HVF examination showing temporal hemianopia in the left eye and unspecified defect on the right eye. The third case, 40 years 40-year-old, presented with vision loss in the left eye for two months. The HVF shows temporal hemianopia in the right eye and is difficult to evaluate due to visual loss in the left eye. The last case, 62 years 62-year-old male, presented with blurry vision in the left eye for two months before. Presenting HVF examination shows the right homonymous hemianopia defect. 

Conclusion: There are many variations of visual field defects in patients with chiasmal syndrome. It is essential to know the anatomical of the optic chiasm and the technique of visual field examination.