The chiasmal syndrome (primary optic atrophy with bitemporal field defects in adult patients showing an essentially normal sella), so commonly produced by suprasellar meningioma, was described in 1927 by Holmes and Sargent1 and confirmed in 1929 and 1930 by Cushing.* A tumor in this position arising from the tuberculum sellae may give as few indications of its presence as any lesion with which the neurosurgeon has to deal. A temporal field cut in one or both eyes plus optic atrophy in the more affected eye may seem very inadequate grounds for suggesting a craniotomy, especially since the sella may not be eroded, headache may not be severe, and evidence of pituitary dysfunction may be lacking. Nevertheless, if these tumors are to be dealt with successfully the decision to operate must be based on these ocular findings alone. When visual symptoms have become marked, and visual loss, field defects, or
GRANT FC, HEDGES TR. Ocular Findings in Meningiomas of the Tuberculum Sellae. AMA Arch Ophthalmol. 1956;56(2):163–170. doi:10.1001/archopht.1956.00930040171001
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