Clinical feature aociated with leion other than pituitary adenoma in patient with an optic chiamal yndrome

Purpoe Pituitary adenoma are the mot common caue of an optic chiamal yndrome, and treatment of thee leion i coniderably different from the treatment of mot of the other leion in thi region. Although the diagnoi of a pituitary adenoma i uually inferred from the reult of neuroimaging, leion other than pituitary adenoma can have an appearance that ugget an adenoma. The objective of our tudy wa to determine whether there are clinical finding that ugget a leion producing a chiamal yndrome i omething other than a pituitary adenoma. Deign Retropective, cae-controlled, analyi of medical record data. Method The record of the Neuro-Ophthalmology Unit of the Wilmer Eye Intitute were earched for patient with a chiamal yndrome who had been evaluated before treatment and for whom pathologic or laboratory confirmation of the etiology wa available. Preenting clinical feature of thee patient were recorded, and analye with both a ingle variable and multiple variable were performed to determine whether there were any feature that could identify with a high degree of probability the etiology of the leion producing the yndrome. Reult The earch revealed 149 patient who met the incluion criteria, including 90 patient with pituitary adenoma and 59 patient with other leion. Variable that were highly uggetive of an etiology other than pituitary adenoma included ymptomatic viual lo, younger age, unilateral optic dik pallor, a relative afferent pupillary defect, and an abolute or a complete viual field defect or one wa greater inferiorly than uperiorly. Concluion Although no ingle clinical feature can be ued to determine the pecific nature of a leion that produce an optic chiamal yndrome, certain feature are highly uggetive of an etiology other than pituitary adenoma. When thee feature are preent, the likelihood that a upraellar leion i a pituitary adenoma i much lower, regardle of the appearance on neuroimaging.