A case with transient refractive change after removal of pituitary tumor

作者：Ishikawa Hiroto^*; Akura Junsuke; Uchida Kazutaka; Ikeda Naohiro; Ikeda Tomohiro; Borlongan Cesar V; Mimura Osamu

来源：BMC Ophthalmology, 2013, 13: UNSP 65.

DOI：10.1186/1471-2415-13-65

• Refractive change
• Trans-sphenoidal surgery
• Hyponatremia

Background: Refractive change can be caused by systemic illnesses such as Lupus erythematosus, thyroid deficiency, and diabetes mellitus. However, refractive change after pituitary tumor removal has so far not been reported. %26lt;br%26gt;Case presentation: A 62-year-old woman presented with blurred near vision 10 days after trans-sphenoidal surgery (TSS) for a pituitary tumor. Around the same time, she experienced intercurrent hyponatremia. The corrected visual acuity of both eyes was 20/20, the spherical equivalent of the right eye was -2.125 diopters, and of the left eye was -2.0 diopters before TSS. However, 11 days after TSS, the spherical equivalent of the right eye changed to -0.75 diopters, and that of left eye changed to -1.125 diopters without hyperglycemia. There were no changes in the corrected visual acuity during the follow-up. %26lt;br%26gt;Conclusion: We demonstrated a case with transient refractive change after TSS. The following mechanism is proposed: Hyponatremia induced by the pituitary tumor removal causes an osmotic change in the aqueous humor with lens swelling. This case report is a reminder to both ophthalmologists and neurosurgeons that ophthalmological factors such as lens thickness and axial length should be taken into account when conducting preoperative examinations especially for patients undergoing TSS.

• 出版日期2013-11-1