International Medical Case Reports Journal (Jul 2023)
Pituitary Macroadenoma with Optic Cupping Masquerading as Normal Tension Glaucoma
Abstract
Anny M Cheng,1– 3,* Scott Schecter,4,* Ricardo Jorge Komotar,5 Joby Tsai,1,2 Shailesh K Gupta1,2 1Department of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA; 2Specialty Retina Center, Coral Springs, FL, USA; 3Department of Ophthalmology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA; 4South Florida Vision, Fort Lauderdale, FL, USA; 5Department of Neurosurgery, University of Miami, Miami, FL, USA*These authors contributed equally to this workCorrespondence: Shailesh K Gupta, Department of Ophthalmology, Broward Health, Fort Lauderdale, FL & Specialty Retina Center, 6280 W Sample Road# 202, Coral Springs, FL, 33067, USA, Tel +1 561 322-3588, Fax +1 754 812-5993, Email [email protected]: When non-glaucomatous disease with disc cupping mimics normal-tension glaucoma (NTG), diagnosis is challenging. The typical optic disc features of glaucomatous disease are often subjective, and often overlap with disc changes in compressive intracranial lesions. Ancillary diagnostic testing such as retinal nerve fiber layer (RNFL) analysis and visual field testing can elevate the index of suspicion of an underlying non-glaucomatous process. We present a case of a nonfunctional macroadenoma coexisting with NTG, although it is unclear if the concurrent brain lesion aggravated or caused it. This case highlights the diagnostic challenge of recognizing optic cupping and non-matching abnormalities in the visual field from a coexisting intracranial lesion, even in the absence of other neurological signs.Keywords: cupping, normal tension glaucoma, pituitary macroadenoma, visual field defects
