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Case Reports
. 2019 Feb 27;11(2):e4149.
doi: 10.7759/cureus.4149.

Bilateral Superior Altitudinal Hemianopsia with Macular Involvement Confirmed by Multifocal Visual Evoked Potential Testing

Fabliha Anbar  1 , Valerie Lerebours  2 , Saad Shaikh  3
Affiliations
Case Reports

Bilateral Superior Altitudinal Hemianopsia with Macular Involvement Confirmed by Multifocal Visual Evoked Potential Testing

Fabliha Anbar et al. Cureus. .

Abstract

We report a case of bilateral superior altitudinal hemianopsia (BSAH) secondary to pituitary microadenoma related inferior optic chiasm damage. A 69-year-old-female developed a BSAH with macular involvement that was initially considered as malingering due to the obscurity of this symptom. The patient presents with multiple risk factors for ischemic disease to the ocular and occipital vessels, persistent migraine, hypothyroidism, and a stable pituitary microadenoma, yet no evidence of tissue ischemia or infarction was noted on imaging that could account for her visual field defects. A prior history of pituitary microadenoma is presumed to be the etiologic cause although the lesion had regressed by the time of presentation.

Keywords: bilateral superior altitudinal hemianopsia; bsah; hemianopsia; levothyroxine; pituitary microadenoma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Left Visual Field
Automated 30-2 visual field demonstrating complete superior hemifield defect with macular involvement in the left eye.
Figure 2
Figure 2. Right Eye Visual Field
Automated 30-2 visual field demonstrating complete superior hemifield defect with macular involvement in the right eye.
Figure 3
Figure 3. Multifocal Visual Evoked Potential
Multifocal visual field (best of responses) of the right (top) and left (bottom) eye demonstrating complete superior visual field loss involving the macula as well. The image at the top is of the right eye, the bottom image is of the left eye.
See this image and copyright information in PMC

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