A case with transient refractive change after removal of pituitary tumor

BMC Ophthalmology

Case Report

Cesar V Borlongan¹  Kazutaka Uchida²  Naohiro Ikeda³  Tomohiro Ikeda³  Osamu Mimura³  Hiroto Ishikawa⁴  Junsuke Akura⁵ 

[1] Department of Neurosurgery and Brain Repair, University of South Florida, 12901 Bruce B. Downs Blvd, MDC78, 33612, Tampa, FL, USA;Department of Neurosurgery, Hyogo College of Medicine, 1-1 Mukogawa-cyo, 663-8501, Nishinomiya, Hyogo, Japan;Department of Ophthalmology, Hyogo College of Medicine, 1-1 Mukogawa-cyo, 663-8501, Nishinomiya, Hyogo, Japan;Department of Ophthalmology, Hyogo College of Medicine, 1-1 Mukogawa-cyo, 663-8501, Nishinomiya, Hyogo, Japan;Department of Ophthalmology, Kushimoto Rehabilitation Center, Kushimoto, Japan;Department of Ophthalmology, Kushimoto Rehabilitation Center, Kushimoto, Japan;

关键词: Refractive change;    Trans-sphenoidal surgery;    Hyponatremia;   

DOI  :  10.1186/1471-2415-13-65

 received in 2012-10-23, accepted in 2013-10-31,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundRefractive change can be caused by systemic illnesses such as Lupus erythematosus, thyroid deficiency, and diabetes mellitus. However, refractive change after pituitary tumor removal has so far not been reported.Case presentationA 62-year-old woman presented with blurred near vision 10 days after trans-sphenoidal surgery (TSS) for a pituitary tumor. Around the same time, she experienced intercurrent hyponatremia. The corrected visual acuity of both eyes was 20/20, the spherical equivalent of the right eye was −2.125 diopters, and of the left eye was −2.0 diopters before TSS. However, 11 days after TSS, the spherical equivalent of the right eye changed to −0.75 diopters, and that of left eye changed to −1.125 diopters without hyperglycemia. There were no changes in the corrected visual acuity during the follow-up.ConclusionWe demonstrated a case with transient refractive change after TSS. The following mechanism is proposed: Hyponatremia induced by the pituitary tumor removal causes an osmotic change in the aqueous humor with lens swelling. This case report is a reminder to both ophthalmologists and neurosurgeons that ophthalmological factors such as lens thickness and axial length should be taken into account when conducting preoperative examinations especially for patients undergoing TSS.

【 授权许可】

CC BY   
© Ishikawa et al.; licensee BioMed Central Ltd. 2013