Dr. Chaithra Dembala Aroor, A14712, Dr. Rohit Shetty, Dr. Abdul Rawoof
65 year old chronic smoker,comes with progressive blurring of vision in both eyes for 2 months.His visual acuity was hand movements in both the eyes.Pupils were sluggish,fundus evaluation revealed severe primary optic atrophy in both the eyes.Temporal arteries were felt and it was not tender nor tortuous.The differential diagnosis were bilateral old ischemic optic neuropathy,toxic & nutritional optic neuropathy or compressive optic neuropathy.Blood tests were done and ESR was 80 mm/hr,CRP positive,hence a tentative diagnosis of bilateral arteritic ischemic optic neuropathy was made and he was planned for intravenous methylprednisolone after neuroimaging.However neuroimaging revealed a giant pituitary macroadenoma and the patient was immediately referred to the Neurosurgeon for further management.Pituitary adenomas are common lesions comprising 10-15 % of all primary brain tumors.Timely referral and prompt neurosurgical intervention results in an overall improved prognosis.