Bitemporal Visual Field Defects Mimicking Chiasmal Compression in Eyes with Retinal Disorders

Abstract

A problem in the sellar area is the first impression that comes into the mind of an ophthalmologist when he/she sees a patient with bitemporal hemianopia, and thanks to that, many intracranial lesions have been found. As the typical and characteristic visual field changes resulting from a damage in the middle part of the optic chiasm where the major nerve fibers come from the nasal sides of binocular retina, bitemporal hemianopia is commonly caused by space-occupying lesions, such as pituitary adenoma, meningioma, craniopharyngioma, and other multiple pathogenic factors, such as inflammation, infection, trauma, and vascular disorders. Therefore, is symmetrical bitemporal visual field impairment always caused by lesions of the chiasm? If not, how to avoid making a diagnosis only by experience? The following cases may bring us some enlightenment.