Chiasmal syndrome ophthalmological and neuro-radiological aspects

J. T. W. van Dalen1, B. J. W. M. Verbeeten1, F. L. M. Peeters1
1Department of Ophthalmology and Roentgenology, University of Amsterdam, Amsterdam, The Netherlands

Tóm tắt

The chiasmal syndrome has distinct ophthalmological features such as visual field loss, optic disc changes, decrease in visual acuity, ocular motor disturbances and exophthalmos. However, the pathological processes in the chiasmal region often give rise to differential diagnostic problems. Before the era of computer tomography (CT) these processes could only be visualized by means of indirect or invasive examination techniques. After introduction of computer tomography these processes could be identified much more easily. The ophthalmological findings are discussed. The most frequent causes of chiasmal syndrome are demonstrated on CT scan. The neuroradiological differential diagnosis of an enlarged sella turcica is given.

Từ khóa


Tài liệu tham khảo

Ambrose J (1973) Computerized transverse axial scanning (tomography): Part 2. Clinical application. Brit J Radiol 46: 1023–1047 Brégeat P (1979) Les syndromes opto-chiasmatiques. Paris, Masson Chamlin M, Davidoff LM and Feiring EH (1955) Ophthalmologic changes produced by pituitary tumors. Amer J Ophthal 40:353–368 van Dalen JTW, Frens AM and Horsten GPM (1977). The visually evoked response (VER) in unsuspected chiasmal lesions. Docum Ophthal Proc Ser 17:221–224 Daniels DL, Haughton VM, Williams AL, Gager WE and Berns TF (1980) Computed tomography of the optic chiasm. Radiology 137:123–127 Doris MS, Apostolidis AS, Stavropoulos AN and Vassiliou GA (1979) The chiasmal syndrome. A study concerning visual field anomalies. XXIII Concilium Ophthalmologicum Kyoto, 1978, Acta; ed: K Shimizu. Amsterdam, Excerpta Medica, p. 1142–1145 Dubois PJ, Orr DP, Hoy RJ, Herbert DL and Heinz ER (1979) Normal sellar variations in frontal tomograms. Radiology 131: 105–110 Elkington SG (1968) Pituitary adenoma; preoperative symptomatology in a series of 260 patients. Brit J Ophthal 52: 322–328 Fahlbusch R, Grumme Th, Aulich A, Wende S, Steinhoff H, Lanksch W and Kazner E (1976) Suprasellar tumors in the CT scan. In: Cranial computerized tomography, ed by W Lanksch and E Kazner. Berlin, Springer, p. 114–127 Gajdos-Preuss A, Schaison M and Fontaine M (1978) Manifestations ophtalmologiques des adénomes hypophysaires. J Fr d'Ophtal 1: 427–438 Glaser JS (1978) Neuro-ophthalmology, Hagerstown, Harper and Row, p. 133 Greve EL and Raakman MAC (1977) On atypical chiasmal visual field defects. Docum Ophthal Proc Ser 17: 315–325 Klauber A, Rasmussen P and Lindholm J (1977) Pituitary adenoma and visual function; the prognostic value of clinical, ophthalmological and neuroradiological findings in 51 patients subjected to operation. Acta Ophthal 56:252–263 Mesiury R, Metzger J, Helias A, Paul D, Schaison G and Cabanis EA (1974) Etude des troubles coexistant avec une ‘selle turcique vide’ en particulier des troubles visuels. Rev Oto-neuro-ophthal 46:417–433 Nachtigäller H and Hoyt WF (1970) Störungen des Seheindruckes bei bitemporaler Hemianopsie und Verschiebung der Sehachsen. Klin Mbl Augenheilk 156: 821–836 Naidich TP, Pinto RS, Kushner MJ, Lin JP, Kricheff II, Leeds NE and Chase NE (1976) Evaluation of sellar and parasellar masses by computed tomography. Radiology 120: 91–99 Osborn AG, Johnson L and Roberts TS (1979) Sphenoidal mucoceles with intracranial extension. J Comput Ass Tomography 3: 335–338 Post M, Donovan J, David NJ, Glaser JS and Safran A (1980) Pituitary apoplexy: diagnosis by computed tomography. Radiology 134: 665–670 Reeder MM and Felson B (1975) Gamuts in radiology. Audiovisual Radiology of Cincinati Robertson WD and Newton Th H (1978) Radiologic assessment of pituitary microadenomas. Amer J Roentgenol 131: 489–492 Rudwan MA (1977) Pituitary abscess. Neuroradiology 12: 243–248 Sachsenweger R (1977) Neuro-ophthalmologie. Stuttgart, Thieme Syvertsen A, Haughton VM, Williams AL, and Cusick JF (1979) The computed tomographic appearance of the normal pituitary gland and pituitary microadenomas. Radiology 133: 385–391 Thun F and Friedmann G (1981) 3. Kopf, Gehirn und intrakranieller Raum. In: Ganzkörper-Computertomographie; hrsg von G Friedmann, E Bücheler und P Thurn. Stuttgart, Thieme Weisberg LA, Nice C and Katz M (1978) Chapter 8: The juxtasellar region-visual, endocrine or radiographic abnormalities. In: Cerebral computed tomography; a textatlas. Philadelphia, Saunders Wiggli U and Benz UF (1978) Normal computed tomography anatomy of the suprasellar subarachnoid space. Radiology 128: 65–70 Wilson P and Falconer MA (1968) Patterns of visual failure with pituitary tumors; clinical and radiological correlations, Brit J Ophthal 52: 94–110