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58-year-old man was seen in the office on 3/29/2011. He has had gradually declining vision in the left eye over about the last 18 months. He has Crohn’s disease and has had sections of his colon resected lately. He notices the right eye sees fine. The left eye has sort of a green tint to it. VISUAL ACUITY: Vision OD is 20/20, OS is 20/160. IOP: OD 13, OS 19. Color vision right eye 10/11 correct, the left eye is 0/0 correct. He has peripheral vision loss in the left eye to confrontation. SLIT LAMP EXAM: There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.5. The macula and periphery look healthy. OS: Vertical C/D ratio is 0.7. The nerve is pale. The macula and periphery look healthy. OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns. PHOTOGRAPHS: Photos confirm clinical findings and do show the optic atrophy in the left eye. The macular scans do show a decreased macular volume in the left eye compared to the right eye. The macular volume in the right eye is 6.4 mm³, the left eye 6.11 mm³. IMPRESSION: 1. OPTIC ATROPHY WITH VISION LOSS – LEFT EYE DISCUSSION: I explained to the patient with the optic atrophy he needs to be evaluated for possible causes. It is possible there may be something nutritional going on, but the asymmetry is suspicious for some sort of a lesion in the orbit. I had ordered an MRI of head and orbit with and without contrast. Unfortunately, the MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss.

opticatrophypittumor_cost01.jpg
Optic Atrophy Left Eye and Benign Pituitary Tumor - VA 20/20 Right Eye 20/160 Left Eye294 views58-year-old man has had gradually declining vision in the left eye over about the last 18 months. Vision OD is 20/20, OS is 20/160
OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns.
MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss. The tumor was resected and was a benign pituitary tumor.
00000
(0 votes)
opticatrophypittumor_cost02.jpg
Optic Atrophy Left Eye and Benign Pituitary Tumor - VA 20/20 Right Eye 20/160 Left Eye196 views58-year-old man has had gradually declining vision in the left eye over about the last 18 months. Vision OD is 20/20, OS is 20/160
OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns.
MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss. The tumor was resected and was a benign pituitary tumor.
00000
(0 votes)
opticatrophypittumor_cost03.jpg
Optic Atrophy Left Eye and Benign Pituitary Tumor - VA 20/20 Right Eye 20/160 Left Eye159 views58-year-old man has had gradually declining vision in the left eye over about the last 18 months. Vision OD is 20/20, OS is 20/160
OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns.
MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss. The tumor was resected and was a benign pituitary tumor.
00000
(0 votes)
opticatrophypittumor_cost04.jpg
Optic Atrophy Left Eye and Benign Pituitary Tumor - VA 20/20 Right Eye 20/160 Left Eye150 views58-year-old man has had gradually declining vision in the left eye over about the last 18 months. Vision OD is 20/20, OS is 20/160
OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns.
MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss. The tumor was resected and was a benign pituitary tumor.
00000
(0 votes)
opticatrophypittumor_cost05.jpg
Optic Atrophy Left Eye and Benign Pituitary Tumor - VA 20/20 Right Eye 20/160 Left Eye210 views58-year-old man has had gradually declining vision in the left eye over about the last 18 months. Vision OD is 20/20, OS is 20/160
OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns.
MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss. The tumor was resected and was a benign pituitary tumor.
00000
(0 votes)
opticatrophypittumor_cost06.png
Optic Atrophy Left Eye and Benign Pituitary Tumor - VA 20/20 Right Eye 20/160 Left Eye185 views58-year-old man has had gradually declining vision in the left eye over about the last 18 months. Vision OD is 20/20, OS is 20/160
OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns.
MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss. The tumor was resected and was a benign pituitary tumor.
00000
(0 votes)
opticatrophypittumor_cost07.png
Optic Atrophy Left Eye and Benign Pituitary Tumor - VA 20/20 Right Eye 20/160 Left Eye219 views58-year-old man has had gradually declining vision in the left eye over about the last 18 months. Vision OD is 20/20, OS is 20/160
OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns.
MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss. The tumor was resected and was a benign pituitary tumor.
00000
(0 votes)
opticatrophypittumor_cost08.png
Optic Atrophy Left Eye and Benign Pituitary Tumor - VA 20/20 Right Eye 20/160 Left Eye227 views58-year-old man has had gradually declining vision in the left eye over about the last 18 months. Vision OD is 20/20, OS is 20/160
OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns.
MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss. The tumor was resected and was a benign pituitary tumor.
00000
(0 votes)
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58-year-old man was seen in the office on 3/29/2011. He has had gradually declining vision in the left eye over about the last 18 months. He has Crohn’s disease and has had sections of his colon resected lately. He notices the right eye sees fine. The left eye has sort of a green tint to it. VISUAL ACUITY: Vision OD is 20/20, OS is 20/160. IOP: OD 13, OS 19. Color vision right eye 10/11 correct, the left eye is 0/0 correct. He has peripheral vision loss in the left eye to confrontation. SLIT LAMP EXAM: There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.5. The macula and periphery look healthy. OS: Vertical C/D ratio is 0.7. The nerve is pale. The macula and periphery look healthy. OCT SCAN: The OCT scan of the nerve fiber layer in the right eye shows a thickness of 88 microns, the left eye 59 microns. PHOTOGRAPHS: Photos confirm clinical findings and do show the optic atrophy in the left eye. The macular scans do show a decreased macular volume in the left eye compared to the right eye. The macular volume in the right eye is 6.4 mm³, the left eye 6.11 mm³. IMPRESSION: 1. OPTIC ATROPHY WITH VISION LOSS – LEFT EYE DISCUSSION: I explained to the patient with the optic atrophy he needs to be evaluated for possible causes. It is possible there may be something nutritional going on, but the asymmetry is suspicious for some sort of a lesion in the orbit. I had ordered an MRI of head and orbit with and without contrast. Unfortunately, the MRI did show a suprasellar mass which is affecting the optic chiasm and is responsible for the vision loss.