Endocrine and neuro-ophtalmologic correlates of primary empty sella

Antonio Bianchi; Bruno Gregori; Eugenia Sacco; Antonella Giampietro; Domenico Milardi; Alessandra Fusco; Neri Accornero; Alfredo Pontecorvi; Marinis Laura De

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Endocrine Abstracts (2007) 14 P602

ECE2007 Poster Presentations (1) (659 abstracts)

Endocrine and neuro-ophtalmologic correlates of primary empty sella

Antonio Bianchi ¹ , Bruno Gregori ² , Eugenia Sacco ¹ , Antonella Giampietro ³ , Domenico Milardi ³ , Alessandra Fusco ¹ , Neri Accornero ² , Alfredo Pontecorvi ¹ & Laura De Marinis ¹

Err

Author affiliations

¹Department of Endocrinology, Catholic University School of Medicine, Rome, Italy; ²Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy; ³International Institute ‘Paolo VI’, Catholic University School of Medicine, Rome, Italy.

Background: Primary empty sella (ES) can be asymptomatic or associated with endocrine and neurological alterations, such as visual defects. Studies in a large number of patients is still lacking.

Objective: To study visual deficit in ES and its relationship with hormonal status.

Material and Methods: We recorded visual evoked potentials (VEP) by white/black, red/black, blue/black patterns. Isoluminance between red and blue checks allowed to compare potentials. We measured P1 latencies and computed a chromatic (blue-red/blue+red) contrast index (CC). Chromatic visual field perimetry was performed with a dedicated computerised system which provides quantitative chromatic maps for each eyes.

We included 64 eyes of 32 normal volunteers (age: 44±14.8) and 10 eyes of 10 ES patients with no systemic disease and increased intracranial pressure (age 50±16.1). On basis of clinical and laboratory data, patients were divided in two groups: with (group A) and without (group B) endocrine abnormalities.

Results: VEP and Visual field perimetry studies showed a significant alterations of both P1 latencies and visual field indices in ES patients as compared to controls. In group A visual alterations appeared more pronounced as compared to group B.

Discussion: Chromatic studies can selectively analyse parallel visual pathways which differ in their physiology and susceptibility to visual pathologies. Data suggest a different disorder of visual systems in ES patient with and without endocrine abnormalities. Studies in a large number of ES patients can provide insights in the pathophysiology of syndrome and more accurate indications for treatment.