Radiation-induced ocular motor cranial nerve palsies in patients with pituitary tumor

Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
Michael S VaphiadesL B Kline

Abstract

Radiation therapy is often used in the treatment of pituitary tumor. Diplopia due to radiation damage to the ocular motor cranial nerves has been infrequently reported as a complication in this clinical setting. Retrospective case series of 6 patients (3 men and 3 women) with pituitary adenoma, all of whom developed diplopia following transsphenoidal resection of pituitary adenoma with subsequent radiation therapy. None had evidence of tumor involvement of the cavernous sinus. Five patients developed sixth nerve palsies, 3 unilateral and 2 bilateral, and in 1 patient, a sixth nerve palsy was preceded by a fourth cranial nerve palsy. One patient developed third nerve palsy. Five of the 6 patients had a growth hormone-secreting pituitary tumor with acromegaly. Following transsphenoidal surgery in all 6 patients (2 had 2 surgeries), 4 had 2 radiation treatments consisting of either radiosurgery (2 patients) or external beam radiation followed by radiosurgery (2 patients). Patients with pituitary tumors treated multiple times with various forms of radiation therapy are at risk to sustain ocular motor cranial nerve injury. The prevalence of acromegalic patients in this study reflects an aggressive attempt to salvage patients with re...Continue Reading

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Citations

Mar 8, 2014·International Ophthalmology·Julio González-Martín-MoroRoberto García-Leal
Jul 23, 2013·Current Opinion in Ophthalmology·Karthikeyan A Sadagopan, Barry N Wasserman
Sep 13, 2019·Neurology India·Yan ChenXiaozhe Shi
Nov 21, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Masaki KatsuraOsamu Abe
Sep 22, 2020·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Trishal Jeeva-PatelEdward Margolin

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