Vision Disturbances in Pituitary Prolactimomas: A Clinical Case Study

Lara Freijah, BOrth&OphthSc(Hons)
Department of Clinical Vision Sciences, La Trobe University, Melbourne, Australia

A pituitary prolactinoma is a benign tumour of the pituitary gland that causes excess production of prolactin, the hormone normally responsible for the formation of milk during pregnancy. It is the commonest type of pituitary tumour and is most prevalent in females under the age of 40. Considering the close proximity of the optic nerves to the pituitary gland, it is imperative that patients diagnosed with this condition undergo regular ophthalmologic examinations, including perimetry, to monitor any potential changes. The visual field defect commonly seen in patients with pituitary tumours is a superotemporal quadrantanopia as the inferonasal fibres are affected. Bitemporal hemianopias are also commonly seen. Aside from the visual disturbances associated with pituitary prolactinomas, affected individuals can also experience infertility, low bone density and hypopituitarism.

A case study of an 18 year old woman diagnosed with a pituitary prolactinoma who interestingly also became pregnant will be presented. It is well documented that women with prolactin-secreting tumours can experience further pituitary enlargement than what is expected in a healthy pregnant woman. The progress of this case was closely examined with MRI scans and perimetry, all of which will be presented.