Rapid deterioration of visual fields during bromocriptine-induced pregnancy in a patient with a pituitary adenoma.

Abstract

Kajtar and Tomkin (1971). In subsequent (induced) pregnancies visual field defects developed, leading to termination of the pregnancy in the 39th week in one case (Corbey), spontaneous regression of the defects after the 36th week of pregnancy (Lamberts), and performance of hypophysectomy in a third patient (Kajtar and Tomkin). In this third case there was gross erosion ofthe posterior clinoids, and a pituitary adenoma was found.Case history A woman, now aged 25 years, was first seen in our ophthalmology department in July 1975, having been referred to us by the gynaecologist. After a period on oral contraceptives (1970-2) she had developed oligomenorrhoea and galactorrhoea, followed in 1973 by amenorrhoea. In July 1975 high prolactin levels were found (87 ng/ml; normal value 20 ng/ml), and it was concluded that this patient had a pro-

Growth of a Prolactinoma During Pregnancy

“…Pregnancy was confirmed by an urinary hCG determination 24 days after ovulation and bromocriptine was discontinued thereafter. During pregnancy, visual fields were examined at monthly intervals and the results have been reported elsewhere (van Dalen and Greve, 1977). At 20 weeks gestation a slight defect in the left temporal upper quadrant was first noted and in the 21st week a bitemporal hemianopia was present and the patient complained of headache and blurred vision.…”