How robust is the optic chiasm? Perimetric and neuro-imaging correlations

Acta Neurol Scand. 2008 Mar;117(3):198-204. doi: 10.1111/j.1600-0404.2007.00927.x. Epub 2007 Sep 12.

Abstract

Objectives: Analysis of form and function relationships with tumour-mediated dislocations and deformations of the optic chiasm.

Materials and methods: Results of magnetic resonance tomography and two forms of quantitative, computerized perimetry were contrasted in 31 patients with pituitary adenomata impinging on the chiasm, prior to treatment.

Results: Perimetric abnormalities ranged from none to modest. High-pass Resolution Perimetry (HRP) produced abnormal results in 10 cases and RareBit perimetry (RBP) in 15 cases. Overall, field defects and qualitative stages of deformation and dislocation of the chiasm were well correlated. Among quantitative indices, the best correlations were obtained by a measure of the cranio-caudal position of the chiasm.

Conclusions: On average, an elevation of the chiasm by 6 mm will be associated with abnormal visual fields in 50% of the cases. An additional elevation of 5 mm will raise the incidence of field defects to 90%.

MeSH terms

  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Optic Chiasm / pathology*
  • Optic Chiasm / physiopathology
  • Optic Nerve Neoplasms / pathology*
  • Optic Nerve Neoplasms / physiopathology
  • Optic Nerve Neoplasms / surgery
  • Pituitary Neoplasms / pathology*
  • Pituitary Neoplasms / physiopathology
  • Pituitary Neoplasms / surgery
  • Visual Acuity / physiology
  • Visual Field Tests / methods*
  • Visual Fields / physiology