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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-In-Chief: Aditya Govindavarjhulla, M.B.B.S. [2] Nihas Raja Mateti, M.B.B.S.[3]

Synonyms and keywords: Bitemporal hemianopsia

Overview

Bitemporal hemianopia (bi-: both eyes, temporal: temporal/peripheral, hemi-: half, anopsia: blindness) is defect in visual pathway causing loss of sight in the outer half of the visual field. A lesion compressing or disrupting optic chiasm would result in bitemporal hemianopia. Additional symptoms such as Headache, Diplopia, Endocrine disorders can be present. Most common causes are Pituitary macroadenoma, Craniopharyngioma, Meningioma and Aneurysm of anterior communicating artery. Visual field defects can be diagnosed using Standard Automated Perimetry (SAP). CT Imaging and MRI usually reveal the underlying cause. While vision loss can be improved by treating the underlying cause, sometimes it can be permanent.

Historical Perspective

  • First case of Bitemporal hemianopsia was reported by Clarence A. Veasey, in 1904 [1].
  • In 1929, L.S.Kubie and J.W.Beckmann documented Diplopia to be the most reported symptom in patients with bitemporal hemianopia in the absence of extraocular muscle palsies.[2]

Classification

  • Bitemporal hemianopia may be classified according to the number of defective optic fibers into complete bitemporal hemianopia and partial bitemporal hemianopia.

Pathophysiology

Comparison of visual field and retinoptic field. Picture courtesy Nihas R Mateti
Comparison of visual field and retinoptic field. Picture courtesy Nihas R Mateti


Causes

Common Causes

Most of the common causes of bitemporal hemianopia are due to disorders of the pituitary gland and its surrounding structures.

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic Dermatochalasis[11]
Drug Side Effect Chloroquine retinopathy[12], Ethambutol toxicity[13]
Ear Nose Throat No underlying causes
Endocrine Pituatary macroadenoma, Prolactinoma
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal / Ortho No underlying causes
Neurologic Craniopharyngioma, Aneurysm of anterior communicating artery, Intracranial vascular loop, Meningioma, Enlarged third ventricle[14], Glioma of third ventricle[15], Chronic chiasmal arachnoiditis[16], Suprasellar tumors[17][17][17][17][17][17][17][17][17][17][17][17][17][17][17][17][17][14][13][13][13][13][13][13], Adamantinoma of sella turcica[17], Optic neuropathy[13][13][13][13][13][13][13][13][13][13][13][13][13][13][13][13][13][8][7][7][7][7][7][7], Traumatic chiasmal syndrome[18], Dolichoectasia of internal carotid arteries[19]
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic Hypophyseal hypertrophy in pregnancy[20]
Oncologic Adamantinoma of sella turcica, Craniopharyngioma, Glioma of third ventricle, Pituitary macroadenoma, Prolactinoma, Meningioma, Suprasellar tumors
Opthalmologic Dermatochalasis, Optic neuropathy, Optic chiasmal syndrome, Bilateral blepharoptosis[21], Traumatic chiasmal syndrome, Retinal disorders[22], Nasal Staphylomata [23], Tilted disc syndrome[24]
Overdose / Toxicity Ethambutol toxicity
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy No underlying causes
Sexual No underlying causes
Trauma Traumatic chiasmal syndrome
Urologic No underlying causes
Dental No underlying causes
Miscellaneous No underlying causes

Differentiating Bitemporal hemianopia from other Diseases

Differential diagnosis of Bitemporal hemianopia

Pituitary adenoma Functional adenoma - Endocrine abnormalities, Non functional adenoma - exert pressure symptoms (Headache). Isointense on MRI.
Suprasellar tumors Craniopharyngioma Headache, Seizure, Focal neurological deficit. Calcified mass with Motor oil like fluid within the tumor on MRI.
Aneurysm of anterior communicating artery Unruptured aneurysm can be asymptomatic or mild headache. Ruptured aneurysms presents with 'Worst headache of life' (Subarachnoid hemorrhage), Seizures, Focal neurological deficit.
Meningioma Headache, Seizure, Focal neurological deficit. Well circumscribed, Extra-axial mass with Dural attachment on MRI. Psammoma bodies on immunohistopathology.

Epidemiology and Demographics

  • The prevalence of pituitary adenoma is approximately 16.7% worldwide. Pituitary adenomas are almost always associated with bitemporal hemianopia.[25]
  • There is no racial predilection to bitemporal hemianopia.

Risk Factors

  • There are no established risk factors for bitemporal hemianopia.

Screening

  • There is insufficient evidence to recommend routine screening for bitemporal hemianopia in a normal population.
  • Patients with asymptomatic pituitary adenomas can be screened by automated perimetry.
  • Presence of Vertical step [SN-96% SP-100%] and Temporal depression[SN-100% and SP-98%] is the criteria for diagnosis of bitemporal hemianopia. [26]

Natural History, Complications, and Prognosis

Natural History

  • In most of the patients, central visual field of 110°–120° (using Goldmann perimetry) is preserved and is sufficient for day to day activities. A volume perimetry demonstrates a binocular scotoma beyond the point of fixation.[27]

Complications

Prognosis

Diagnosis

Diagnostic Study of Choice

Bitemporal hemianopsia Nihas
Bitemporal hemianopsia. Picture courtesy by Nihas R Mateti.



History and Symptoms

Physical Examination

  • Physical examination of patients with bitemporal hemianopia is usually normal.

Laboratory Findings

  • There are no diagnostic laboratory findings associated with bitemporal hemianopia.

Electrocardiogram

  • There are no ECG findings associated with bitemporal hemianopia.

X-ray

  • There are no x-ray findings associated with bitemporal hemianopia.

Echocardiography or Ultrasound

  • There are no echocardiography/ultrasound findings associated with bitemporal hemianopia.
  • However, B-scan ultrasonography may be helpful in the diagnosis of bitemporal hemianopia when etiology is Nasal staphylomata.[23]

CT scan

  • Brain CT scan showing a mass near optic chiasm may be helpful in the identifying underlying cause of bitemporal hemianopia.
  • Calcifications can be seen in craniopharyngiomas.[37]
  • Menigiomas are moderately hyperdense before contrast enhancement and have no or minimal calcification.[38]

MRI

  • Brain MRI showing a mass near optic chiasm may be helpful in the identifying underlying cause of bitemporal hemianopia. Compression of optic chiasm by tumor can be graded from 0-4.[26]
  • Extent and the relation of craniopharyngioma to other structures can be clearly seen in MRI than CT scan.[37]

Treatment

Medical Therapy

Radiation Therapy

  • Radiation therapy can be used as an adjuvant to medical therapy and surgical therapy to prevent remission.
  • Gamma-knife therapy has seen a recent success in normalizing hormonal hypersecretion in patients who are not suitable candidates for surgery. A 90.3% tumor control had been achieved in microdenomas.[41][42]
  • Stereotactic radiosurgery is being considered in the treatment of parasellar meningiomas.[43]

Surgery

  • Surgery is the mainstay of treatment for bitemporal hemianopia.
  • Pituitary adenoma:
    • Transsphenoidal pituitary surgery is the first line surgery for pituitary adenomas. Visual improvement occurs in 87% of those with preoperative visual loss. It has a mortality rate of 0.5%.[44]
    • A meta-analysis of endoscopic vs microscopic surgery hasn't been statistically significant but endoscopic route has been attributed to increased vascular complications.[45]
  • Meningioma:
    • A fronto-orbital approach for tumor excision is preferred. Visual defect has been resolved post-operatively.[9]

Primary Prevention

  • There are no established measures for the primary prevention of bitemporal hemianopia.

Secondary Prevention

  • There are no established measures for the secondary prevention of bitemporal hemianopia.

References

  1. Veasey CA (1904). "Observations of a case of bi-temporal hemianopsia with some unusual changes in the visual fields". Trans Am Ophthalmol Soc. 10 (Pt 2): 383–7. PMC 1322445. PMID 16692037.
  2. Kubie, L. S.; Beckmann, J. W. (1929). "DIPLOPIA WITHOUT EXTRA-OCULAR PALSIES, CAUSED BY HETERONYMOUS DEFECTS IN THE VISUAL FIELDS ASSOCIATED WITH DEFECTIVE MACULAR VISION". Brain. 52 (3): 317–333. doi:10.1093/brain/52.3.317. ISSN 0006-8950.
  3. "The Retinotopic Representation of the Visual Field - Neuroscience - NCBI Bookshelf".
  4. Hedges TR (1969). "Preservation of the upper nasal field in the chiasmal syndrome: an anatomic explanation". Trans Am Ophthalmol Soc. 67: 131–41. PMC 1310336. PMID 5381296.
  5. Bergland R (1969). "The arterial supply of the human optic chiasm". J Neurosurg. 31 (3): 327–34. doi:10.3171/jns.1969.31.3.0327. PMID 5811834.
  6. McIlwaine GG, Carrim ZI, Lueck CJ, Chrisp TM (2005). "A mechanical theory to account for bitemporal hemianopia from chiasmal compression". J Neuroophthalmol. 25 (1): 40–3. doi:10.1097/00041327-200503000-00011. PMID 15756133.
  7. Lake MG, Krook LS, Cruz SV (2013). "Pituitary adenomas: an overview". Am Fam Physician. 88 (5): 319–27. PMID 24010395.
  8. Müller HL (2014). "Craniopharyngioma". Endocr Rev. 35 (3): 513–43. doi:10.1210/er.2013-1115. PMID 24467716.
  9. 9.0 9.1 Bejjani GK, Cockerham KP, Kennerdell JS, Maroon JC (2002). "Visual field deficit caused by vascular compression from a suprasellar meningioma: case report". Neurosurgery. 50 (5): 1129–31, discussion 1131-2. doi:10.1097/00006123-200205000-00033. PMID 11950417.
  10. Seung WB, Kim DY, Park YS (2015). "A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia". J Korean Neurosurg Soc. 58 (3): 291–3. doi:10.3340/jkns.2015.58.3.291. PMC 4630364. PMID 26539276.
  11. Fay A, Lee LC, Pasquale LR (2003). "Dermatochalasis causing apparent bitemporal hemianopsia". Ophthalmic Plast Reconstr Surg. 19 (2): 151–3. doi:10.1097/01.IOP.0000055827.78632.CA. PMID 12644764.
  12. Goldhammer, Y.; Smith, J. L. (1974). "Bitemporal hemianopia in chloroquine retinopathy". Neurology. 24 (12): 1135–1135. doi:10.1212/WNL.24.12.1135. ISSN 0028-3878.
  13. 13.0 13.1 Boulanger Scemama E, Touitou V, Le Hoang P (2013). "[Bitemporal hemianopia as presenting sign of severe ethambutol toxicity]". J Fr Ophtalmol. 36 (9): e163–7. doi:10.1016/j.jfo.2012.12.008. PMID 24094504.
  14. Osher, R. H.; Corbett, J. J.; Schatz, N. J.; Savino, P. J.; Orr, L. S. (1978). "Neuro-ophthalmological complications of enlargement of the third ventricle". British Journal of Ophthalmology. 62 (8): 536–542. doi:10.1136/bjo.62.8.536. ISSN 0007-1161.
  15. Thavaratnam LK, Loy ST, Gupta A, Ng I, Cullen JF (2015). "Chordoid glioma". Singapore Med J. 56 (11): 641–3. doi:10.11622/smedj.2015175. PMC 4656874. PMID 26668411.
  16. GIBBS DC (1959). "Chiasmal arachnoiditis". Br J Ophthalmol. 43 (1): 52–6. doi:10.1136/bjo.43.1.52. PMC 512211. PMID 13618533.
  17. 17.0 17.1 Lodge WO (1946). "BITEMPORAL HEMIANOPIA". Br J Ophthalmol. 30 (5): 276–81. PMC 510604. PMID 18170220.
  18. Yazici, Bulent (2015). "Isolated Bitemporal Hemianopsia Due to Traumatic Chiasmal Syndrome". Turkish Journal of Trauma and Emergency Surgery. doi:10.5505/tjtes.2015.90540. ISSN 1306-696X.
  19. Slavin ML (1990). "Bitemporal hemianopia associated with dolichoectasia of the intracranial carotid arteries". J Clin Neuroophthalmol. 10 (1): 80–1. PMID 2139057.
  20. PEARCE HM (1963). "PHYSIOLOGIC BITEMPORAL HEMIANOPSIA IN PREGNANCY". Obstet Gynecol. 22: 612–4. PMID 14082282.
  21. Levine BM, Lelli GJ (2010). "Bitemporal hemianopia caused by bilateral blepharoptosis". Orbit. 29 (6): 351–3. doi:10.3109/01676830.2010.516467. PMID 21158577.
  22. "Bitemporal Hemianopia Caused by Retinal Disease". Archives of Ophthalmology. 127 (12): 1686. 2009. doi:10.1001/archophthalmol.2009.320. ISSN 0003-9950.
  23. 23.0 23.1 Gupta, Anjali; Smith, J. M. Alaric (2015). "Bitemporal Hemianopia Secondary to Nasal Staphylomata". Journal of Neuro-Ophthalmology. 35 (1): 99–101. doi:10.1097/WNO.0000000000000202. ISSN 1070-8022.
  24. Manfrè L, Vero S, Focarelli-Barone C, Lagalla R (1999). "Bitemporal pseudohemianopia related to the "tilted disk" syndrome: CT, MR, and fundoscopic findings". AJNR Am J Neuroradiol. 20 (9): 1750–1. PMC 7056191 Check |pmc= value (help). PMID 10543654.
  25. Ezzat S, Asa SL, Couldwell WT, Barr CE, Dodge WE, Vance ML; et al. (2004). "The prevalence of pituitary adenomas: a systematic review". Cancer. 101 (3): 613–9. doi:10.1002/cncr.20412. PMID 15274075.
  26. 26.0 26.1 Fujimoto N, Saeki N, Miyauchi O, Adachi-Usami E (2002). "Criteria for early detection of temporal hemianopia in asymptomatic pituitary tumor". Eye (Lond). 16 (6): 731–8. doi:10.1038/sj.eye.6700165. PMID 12439668.
  27. 27.0 27.1 Peli E, Satgunam P (2014). "Bitemporal hemianopia; its unique binocular complexities and a novel remedy". Ophthalmic Physiol Opt. 34 (2): 233–42. doi:10.1111/opo.12118. PMC 3947624. PMID 24588535.
  28. Bansal, Shveta; Kumar, Nishant; Kyle, Graham (2006). "Mechanism of Bitemporal Hemianopia". Journal of Neuro-Ophthalmology. 26 (3): 233. doi:10.1097/01.wno.0000235584.87674.9d. ISSN 1070-8022.
  29. Vellayan Mookan L, Thomas PA, Harwani AA (2018). "Traumatic chiasmal syndrome: A meta-analysis". Am J Ophthalmol Case Rep. 9: 119–123. doi:10.1016/j.ajoc.2018.01.029. PMC 5861742. PMID 29577103.
  30. "Internet Scientific Publications".
  31. Berkmann, S; Fandino, J; Müller, B; Kothbauer, KF; Henzen, C; Landolt, H (2013). "Reply to the letter to the Editor "Visual outcomes after pituitary surgery"". Swiss Medical Weekly. doi:10.4414/smw.2013.13803. ISSN 1424-7860.
  32. Lampropoulos KI, Samonis G, Nomikos P (2013). "Factors influencing the outcome of microsurgical transsphenoidal surgery for pituitary adenomas: a study on 184 patients". Hormones (Athens). 12 (2): 254–64. doi:10.14310/horm.2002.1409. PMID 23933694.
  33. Mortini P, Losa M, Barzaghi R, Boari N, Giovanelli M (2005). "Results of transsphenoidal surgery in a large series of patients with pituitary adenoma". Neurosurgery. 56 (6): 1222–33, discussion 1233. doi:10.1227/01.neu.0000159647.64275.9d. PMID 15918938.
  34. Tagoe NN, Essuman VA, Bankah P, Dakurah T, Hewlett VK, Akpalu J; et al. (2019). "Visual Outcome of Patients with Pituitary Adenomas Following Surgery and Its Contributory Factors at a Tertiary Hospital in Ghana". Ethiop J Health Sci. 29 (1): 895–902. doi:10.4314/ejhs.v29i1.11. PMC 6341437. PMID 30700957.
  35. Katz J, Tielsch JM, Quigley HA, Sommer A (1995). "Automated perimetry detects visual field loss before manual Goldmann perimetry". Ophthalmology. 102 (1): 21–6. doi:10.1016/s0161-6420(95)31060-3. PMID 7831036.
  36. Monteiro, Mário Luiz Ribeiro; Moura, Frederico Castelo; Cunha, Leonardo Provetti (2007). "Frequency doubling perimetry in patients with mild and moderate pituitary tumor-associated visual field defects detected by conventional perimetry". Arquivos Brasileiros de Oftalmologia. 70 (2): 323–329. doi:10.1590/S0004-27492007000200024. ISSN 0004-2749.
  37. 37.0 37.1 Tsuda M, Takahashi S, Higano S, Kurihara N, Ikeda H, Sakamoto K (1997). "CT and MR imaging of craniopharyngioma". Eur Radiol. 7 (4): 464–9. doi:10.1007/s003300050184. PMID 9204320.
  38. New PF, Hesselink JR, O'Carroll CP, Kleinman GM (1982). "Malignant meningiomas: CT and histologic criteria, including a new CT sign". AJNR Am J Neuroradiol. 3 (3): 267–76. PMID 6805276.
  39. Krzizok T, Schwerdtfeger G (2006). "[Bitemporal hemianopia in road traffic]". Klin Monbl Augenheilkd. 223 (9): 775–9. doi:10.1055/s-2006-926999. PMID 16986090.
  40. Oki Y (2014). "Medical management of functioning pituitary adenoma: an update". Neurol Med Chir (Tokyo). 54 (12): 958–65. PMC 4533360. PMID 25446388.
  41. Jackson IM, Norén G (1999). "Role of gamma knife therapy in the management of pituitary tumors". Endocrinol Metab Clin North Am. 28 (1): 133–42. doi:10.1016/s0889-8529(05)70060-8. PMID 10207688.
  42. Sheehan JP, Pouratian N, Steiner L, Laws ER, Vance ML (2011). "Gamma Knife surgery for pituitary adenomas: factors related to radiological and endocrine outcomes". J Neurosurg. 114 (2): 303–9. doi:10.3171/2010.5.JNS091635. PMID 20540596.
  43. Cohen-Inbar O, Tata A, Moosa S, Lee CC, Sheehan JP (2018). "Stereotactic radiosurgery in the treatment of parasellar meningiomas: long-term volumetric evaluation". J Neurosurg. 128 (2): 362–372. doi:10.3171/2016.11.JNS161402. PMID 28338439.
  44. "Surgical Treatment of Pituitary Adenomas - Endotext - NCBI Bookshelf".
  45. Ammirati M, Wei L, Ciric I (2013). "Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: a systematic review and meta-analysis". J Neurol Neurosurg Psychiatry. 84 (8): 843–9. doi:10.1136/jnnp-2012-303194. PMC 3717601. PMID 23243265.

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