The Relationship Between Sellar Tumors and Glaucoma

Abstract

Since sellar tumors are usually anatomically adjacent to optic nerves, optic chiasm, and optic tracts, tumor-induced compressive injury is common, which may cause eye diseases, such as papilledema and optic atrophy. Glaucoma refers to an optic neuropathy in which intraocular hypertension is the major risk factor; the typical clinical manifestations are optic disk changes and visual field defects. The clinical features of sellar tumors and glaucoma are distinct (especially in optic disk and visual field). The differential diagnosis between sellar tumors and glaucoma is challenging. From the perspective of ophthalmology, the main concern is how to avoid misdiagnosis of sellar tumors; meanwhile, from the perspective of neurosurgery, the clinicians should pay more attention to the identification of glaucoma in patients with sellar tumor. Both disciplines did not consider it as a whole. When considering from the perspective of integrated medicine (IM), we realize that there are a number of problems waiting for further discussion and practical solutions. To be more specific, is it a mere coincidence or inherent correlation that the glaucoma-like optic nerve neuropathy and sellar tumors appear simultaneously? If sellar tumor and glaucoma occur in one patient, then do they exactly belong to one disease or not? Utilizing the thinking way of IM, we will come to realize the limitation on clinic treatment in the past. Plus, it will initiate our wider ponder in this specific vicinity, such as whether it would result in susceptibility to glaucoma optic nerve damage that the sellar tumor has direct influence on anterior optic path. Or could exploration in the deeper way be developed as whether there is an underlying mechanism that the sellar tumor will result in glaucoma, and vice versa? Meanwhile, when they both occur simultaneously, does it have inherent correlation with other areas, such as endocrinology and psychosomatic medicine? With utilizing the concepts from IM, the diagnosis and treatment for diseases would be more comprehensive and systematic.