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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is There Any Relation Between Optic Atrophy And Pineal Cyst ?

I thought I needed glasses as I noticed diminishing vision in my left eye. I have never worn glasses. Upon examination eye doctor sent me to an opthamologist who diagnosed me with optic atrophy (inferior altitudinal visual defect), Two weeks ago I had a MRI that does not reveal MS legions or tumors. I had a MRI three years ago for facial twitching. MRI unremarkable except approx. 7 x 5 mm that my neurologist was not concerned about. I have a follow-up with a nuero opthamologist tomorrow... Could the optic atrophy be related to the pineal cyst, especially if the pineal cyst has grown from 2009 to date? I do not have my radiologist report from the recent MRI.
Thu, 5 Apr 2012
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Ophthalmologist 's  Response
Dear Friend,

Your description suggests your concern regarding the cause of your visual field loss. Pineal cyst or any enlargement of pineal gland usually does not lead to a visual field defect that to limited to only one eye. any brain lession will lead to visual filed loss and will be seen in both eyes simultaneously. Pineal gland enlargement rarely leads to generalised optic atrophy secondary to disc oedema (a false localising sign due to raised intracranial pressure secondary to blockage or cerebral fluid). your left eye inferior altitudnal defect will be probably due to anterior ischemic optic neuropathy (commonest cause of visual field defect as in your case) secondary to the blockage of vascular flow to your optic nerve. please complete your neurological and ophthalmic examinations. Take Care
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Ophthalmologist Dr. Martin Worrall's  Response
Sounds like you have optic neuritis rather than optic atrophy.

The absence of demyelinating lestions in your brain is definately positive, but the presence of a prior neurologic event does indicate that the label of multiple sclerosis could be applicable... this is really a semantic argument at the point hower.

The absence of plaques in association with this current demyelinating episode is positive. If plaques are present there is an indication for intravenous steroid treatment to decrease the likelihood of developing multiple schlerosis during the first 2 years after the development of optic neuritis.

The pineal cyst is far from the visual pathway so is unlikely to have anything to do with your visual loss.
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Is There Any Relation Between Optic Atrophy And Pineal Cyst ?

Dear Friend, Your description suggests your concern regarding the cause of your visual field loss. Pineal cyst or any enlargement of pineal gland usually does not lead to a visual field defect that to limited to only one eye. any brain lession will lead to visual filed loss and will be seen in both eyes simultaneously. Pineal gland enlargement rarely leads to generalised optic atrophy secondary to disc oedema (a false localising sign due to raised intracranial pressure secondary to blockage or cerebral fluid). your left eye inferior altitudnal defect will be probably due to anterior ischemic optic neuropathy (commonest cause of visual field defect as in your case) secondary to the blockage of vascular flow to your optic nerve. please complete your neurological and ophthalmic examinations. Take Care