Carotid-Falciform Optic Neuropathy: Microsurgical Treatment

Left-right and upper-lower light sensitivity asymmetry in visual field defects caused by pituitary adenoma: a retrospective observational study

“…The mechanism for higher frequencies of severe scotoma in the inferonasal compared to the superonasal quadrant of the visual field may implicate compression of the prechiasmal optic nerve against the falciform ligament, which has been reported recently in neurosurgical literature. [10][11][12]18 The optic nerve is roofed by the falciform ligament, which forms the sharp edge of a dural fold where it enters the optic canal anterior to the chiasm. It has been reported that compression of the optic nerve against the falciform ligament caused by the ectatic internal carotid artery may result in visual field defects, which could be resolved with microvascular decompression surgery.…”

“…It has been reported that compression of the optic nerve against the falciform ligament caused by the ectatic internal carotid artery may result in visual field defects, which could be resolved with microvascular decompression surgery. 11,12,18 Meningiomas that elevate the optic nerve from below and cause compression against the falciform 8 ligament have also been reported to cause inferior altitudinal hemianopsia. 10 When the optic chiasm is elevated by an inferiorly-placed pituitary tumor, the superotemporal portion of the optic nerve fibers might become more damaged by the compression against the falciform ligament, leading to visual field damage in the inferonasal quadrant.…”

“…9 Another possible mechanism of the lower-dominant visual field defects in the nasal hemifield may be compression of the prechiasmal optic nerve against the falciform ligament, which has recently been suggested in the neurosurgical literature of visual field defects. [10][11][12] While several researches have investigated asymmetric visual field defects in patients with pituitary adenoma, 4,6,13 no precise investigation with statistical analysis regarding the inter-eye and intra-eye symmetry of visual field defects has yet been reported. In this study, we conducted quantitative analysis to explore the asymmetric properties of visual field defects in pituitary adenoma patients.…”

<p>Left-Right and Upper–Lower Light Sensitivity Asymmetry in Visual Field Defects Caused by Pituitary Adenoma: A Retrospective Observational Study</p>

“…The mechanism for higher frequencies of severe scotoma in the inferonasal compared to the superonasal quadrant of the visual field may implicate compression of the prechiasmal optic nerve against the falciform ligament, which has been reported recently in neurosurgical literature. [15][16][17][18] The optic nerve is roofed by the falciform ligament, which forms the sharp edge of a dural fold where it enters the optic canal anterior to the chiasm. It has been reported that compression of the optic nerve against the falciform ligament caused by the ectatic internal carotid artery may result in visual field defects, which could be resolved with microvascular decompression surgery.…”

“…It has been reported that compression of the optic nerve against the falciform ligament caused by the ectatic internal carotid artery may result in visual field defects, which could be resolved with microvascular decompression surgery. [16][17][18] Meningiomas that elevate the optic nerve from below and cause compression against the falciform ligament have also been reported to cause inferior altitudinal hemianopsia. 15 When the optic chiasm is elevated by an inferiorly placed pituitary tumor, the superotemporal portion of the optic nerve fibers might become more damaged by the compression against the falciform ligament, leading to visual field damage in the inferonasal quadrant.…”