|Year : 1982 | Volume
| Issue : 4 | Page : 251-252
The value of colour fields in diagnosing of pituitary tumours
TR Swaminathan, P Narendran
Institute of Neurology, Govt. General Hospital, Madras, India
T R Swaminathan
Institute of Neurology, Govt. General Hospital, Madras
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Swaminathan T R, Narendran P. The value of colour fields in diagnosing of pituitary tumours. Indian J Ophthalmol 1982;30:251-2
|How to cite this URL:|
Swaminathan T R, Narendran P. The value of colour fields in diagnosing of pituitary tumours. Indian J Ophthalmol [serial online] 1982 [cited 2020 Apr 7];30:251-2. Available from: http://www.ijo.in/text.asp?1982/30/4/251/29441
Unlike the tumours of the brain that arise elsewhere in which the field changes are both due to the accompanying papilledema and the tumour itself, the tumours of the pituitary region are singularly remarkable in presenting as a normal disc or as a pale disc with field changes that are quite pathognomonic of pituitary region.
Colour testing is a delicate test wherein a weak stimulus is applied over a large area of the retina as against the testing with a small white test object wherein a strong stimulus is applied over a, minute area of the retina. Fourteen cases or pituitary tumours attended in a period of seven months from January 1980 to July 1980.
The age of affection was also quite different in both sexes. In men it was between 40-60 years of age and in women between 20-40 years of age.
The presenting symptom in men were defective vision in 6 cases followed by headache in 4, and loss of libido in 4. While in women headache, defective vision and amennorhea were present in all the cases, loss of libido in 3 cases and appearance of papilledema in fundus in one case. One woman had a high Post Prandial blood sugar of 380 mg, and another had other cranial nerve involvement like that of a ophthalmoplegia plus.
The visual acuity was between 6/6 and 6/12 in ten eyes, between 6/18 and 6/60 in six eyes and in the rest be]ow 6/60.
Coming to the field studies proper as shown in [Table - 1] only in six patients field studies were possible in both eyes. Whether the field loss was on the temporal isopter, nasal isopter whether limited by a few degree or appeared as a general constriction or irregular constriction or irregular constriction, there was a marked and disproportionate loss of colour field in all or these cases.
In the case of three eyes which had a normal field for white, the field for red object was markedly constricted first. In two cases of marked constriction for white, the red object was not perceived at all. It was not possible to say whether the tumour was prefixed or post fixed and also the type of tumour by the field charts alone. All the tumours excepting in two cases showed changes in radiography suggestive of a space occupying lesion in the pituitary fossa which was confirmed by carotid angiogram, and in those two cases Pneumo-encephalogram confirmed the same.
| Discussion|| |
In cases of tumours of the pituitary region colour field with 10 mm red object showed a disproportionate loss compared to that of 3 mm white object. The truth of the response of the patients could be verified as the colour of the obiect could be varied at our will without the patient being aware of it. Patient evinces a keener interest while responding to colour test than the monotonus routine test in identifying the appearance and disappearance of a white object. Field charting with red object in suspected pituitary tumours is still a valuable tool in the hands of an ophthalmologist and is all the more important in those cases with progressive loss of vision without any other signs and in two cases there were no radiological evidence but only field defects.
[Table - 1]