GLOKOM TANISI İLE TAKİP EDİLEN HASTADA HİPOFİZ ADENOMU TESPİTİ

Öz

Bilateral glokom tanısı ile izlenen hasta kontrol amacıyla göz polikliniğimize başvurdu. Özgeçmişinde başka bir hastalığı olmayan hastanın göz içi basıncı her iki gözde dorzolomid timolol kombinasyonu ile 10 mmHg olarak tespit edildi. Her iki gözünün de görme keskinliği snellen eşeli ile 0,3 düzeyindeydi. Gonyoskopide her iki göz de açık açı izlenirken, psödoexfoliasyon izlenmedi. Arka segmentte ise her iki papillada solukluk tespit edildi. Papilladaki diffüz solukluğa çukurluk eşlik etmediği görüldü. Bu bulgularla glokom tanısından uzaklaşıp intrakranial patolojiden şüphelenildi. Hastadan görme alanı ve kranial MR istendi. Kranial MR’da 12x9 mm boyutlarında hipofiz adenomu, görme alanında konsantrik daralma tespit edildi ve hasta intrakranial cerrahiye yönlendirildi. Bu bulgular sonrası antiglokomatöz ilacı kesildi. Glokom tanısı koyulurken veya takibi sırasında mutlaka papilla çok iyi incelenmeli intrakranial kitleler akla getirilmeli ve atlanmamalıdır

Anahtar Kelimeler

• Glokom,hipofiz adenomu,optik sinir başı

DIAGNOSIS OF A PITUITARY ADENOMA IN ONE GLAUCOMA FOLLOW-UP PATIENT

Abstract

The patient under bilateral glaucoma follow-up admitted to our clinic for routine control. The medical history of the patient was unremarkable, and his intraocular pressure was measured as 10 mmHg in both eyes with a combination of dorzolamide/timolol. Visual acuity was 0.3 on the Snellen Scale in both eyes. Slit lamp examination revealed bilateral nuclear cataracts in the anterior segment. Open-angle was detected in both eyes on gonioscopy, but pseudoexfoliation was not observed. Pallor was detected in the posterior segment of both papillas. It was observed that optic disc cupping did not accompany to diffuse pallor. On the basis of these findings, the diagnosis of glaucoma was abandoned but intracranial pathology was suspected. Visual field and cranial MRI were planned. Cranial MRI demonstrated 12x9 mm pituitary adenoma, and concentric visual field constriction and the patient was referred to intracranial surgery. Based on these results, antiglaucoma medication was stopped. Consequently, papilla should be carefully examined and intracranial masses should be considered during the diagnosis and follow-up

Keywords

• Glaucoma,pituitary adenoma,optic nerve head

Kaynakça

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10. Yazının alınma tarihi:16.01.12014 Kabül tarihi:10.02.2014 Online basım:15.02.2014