Atlas of Ophthalmology

Compressive Optic Neuropathy, Pituitary Macroadenoma (#1)

Compressive Optic Neuropathy, Pituitary Macroadenoma (#1)
This patient had a pituitary tumor that extended into the suprasellar cistern and compressed the optic chiasm. Selective damage to decussating nasal fibers resulted in the distinctive pattern of optic atrophy seen here. In each eye, nerve fiber layer striations are absent both nasal and temporal to the disc, reflecting loss of peripheral nasal fibers and fibers of nasal macular origin, respectively. In addition, the corresponding nasal and temporal sectors of the neuro-retinal rim exhibit pathologic pallor. This swath of pallor extending horizontally across both optic discs is often referred to as "band" or "bow-tie" atrophy. It is the classic fundus manifestation of chronic chiasmal injury.
Tan Aik Kah, M.D., Universiti Malaysia Sarawak¦2, Kuching, Malaysia
D35.2
Optic Nerve -> Optic Neuropathies -> Compressive Optic Neuropathies
7467
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