Purpose: The purpose of this report is to present the cases of four patients who developed complications of chiasmal tumors while undergoing treatment for normal-tension glaucoma and to investigate findings based on which chiasmal tumor complications should be suspected.
Case presentation: Chiasmal tumor complications included pituitary adenomas in three patients and tuberculum sellae meningioma in one patient. All patients presented with rapid progression of visual field defects and decreased visual acuity in one or both eyes. Optic disc pallor was observed in two patients but was not observed in the remaining two. In patient 1, findings of bitemporal hemianopsia were first detected in visual field testing of the inner 10° of vision.
Conclusions: Ophthalmological findings suggesting chiasmal tumor complications in glaucoma include visual field defects with vertical meridian as a boundary, rapid visual acuity loss and visual field deterioration, and optic disc pallor. However, distinguishing bitemporal hemianopsia findings in advanced glaucoma patients may be difficult, and visual field testing of the inner 10° of vision is useful in some cases. If chiasmal tumor complications are suspected, intracranial imaging should be proactively performed.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 1101-1108, 2019.