Left-Right and Upper–Lower Light Sensitivity Asymmetry in Visual Field Defects Caused by Pituitary Adenoma: A Retrospective Observational Study
Received 18 October 2019
Accepted for publication 8 January 2020
Published 31 January 2020 Volume 2020:14 Pages 317—324
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Yumi Kotoda, 1 Masakazu Kotoda, 2 Masakazu Ogiwara, 3 Hiroyuki Kinouchi, 3 Hiroyuki Iijima 1
1Department of Ophthalmology, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan; 2Department of Anesthesiology, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan; 3Department of Neurosurgery, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
Correspondence: Yumi Kotoda 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
Purpose: The purpose of this study was to quantitatively investigate light sensitivity asymmetry both between left and right eyes and between upper and lower quadrant in the 30-degree visual field of patients with visual field defects caused by pituitary adenoma.
Patients and Methods: Preoperative Humphrey 30– 2 perimetry results were reviewed retrospectively using the charts of 28 pituitary adenoma patients who underwent surgery. Inter-eye light sensitivity comparisons of the temporal and nasal hemifields between the left and right eyes were conducted in each patient to study left-right asymmetry. Upper-lower asymmetry was investigated by comparing the frequency of severe scotoma (light sensitivity 5 dB or less) in the upper and lower visual field quadrants in the temporal and nasal hemifields.
Results: Left-right asymmetry was demonstrated in 61% of cases in the temporal hemifield and in 57% of cases in the nasal hemifield. Severe scotoma test points were investigated in the worse eye of each patient and were more frequent in the superotemporal quadrant of the visual field compared with the inferotemporal quadrant (P = 0.00029) and in the inferonasal quadrant compared to the superonasal quadrant (P = 0.00268).
Conclusion: Asymmetric visual field defects between left and right eyes are common in patients with pituitary adenoma. Severe scotoma is more frequent in the upper quadrant of the temporal hemifield and in the lower quadrant of the nasal hemifield.
Keywords: bitemporal hemianopsia, pituitary adenoma, asymmetry, Humphrey perimetry, light sensitivity
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