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Chiasmal Disorders

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Encyclopedia of Ophthalmology


Lesions of the optic chiasm; Parasellar lesions; Suprasellar mass lesions


A chiasmal disorder defined as any lesion that causes a disruption in the optic chiasm.


The majority of optic chiasmal lesions in adults are caused by compressive suprasellar or parasellar lesions, such as:

  1. 1.

    Pituitary adenomas.

  2. 2.


  3. 3.


  4. 4.

    Internal carotid suprasellar aneurysm.

  5. 5.

    Dysgerminoma and hypothalamic/optic chiasmal glioma in younger patients.

  6. 6.

    Other infrequent causes of chiasmal disorders are demyelination (chiasmal neuritis), metabolic, toxic, traumatic, ischemic, infiltrative, inflammatory, or infectious.

The anatomical location of the optic chiasm (superior in relation to the sellae and inferior to the third ventricle) often determines the affected visual fibers and the visual defects. For example, a prefixed chiasm over the tuberculum occurs in 9 %, the central body of the chiasm is directly above the pituitary in 80 % (leading to the...

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Further Reading

  • Brazis PW, Masdeu JC, Biller J (2012) Localization in clinical neurology. Lippincott Williams & Wilkins, Philadelphia, PA, USA

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  • Foroozan R (2003) Chiasmal syndromes. Curr Opin Ophthalmol 14(6):325–31

    Article  PubMed  Google Scholar 

  • Gruppetta M, Mercieca C, Vassallo J (2012) Prevalence and incidence of pituitary adenomas: a population based study in Malta. Pituitary [Epub ahead of print]

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  • Lee AG, Brazis PW, Miller NR, Newman NJ (2005) Clinical pathways in neuro-ophthalmology: an evidence-based approach. Topical diagnosis of acquired optic nerve disorders. In: Miller NR, Newman NJ (eds) Walsh and Hoyt’s clinical neuro ophthalmology, 6th edn. Lippincott Williams & Wilkins, Baltimore, pp. 228–229

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  • Miller NR, Newman NJ (eds) (2005) Walsh & Hoyt’s clinical neuro-ophthalmology, 6th edn. Lippincott Williams & Wilkins, Philadephia, PA, USA

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Correspondence to Nagham Al-Zubidi , Whitlow Bryan Thomas or Andrew G. Lee .

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© 2015 Springer Science Business Media, New York (outside the USA)

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Al-Zubidi, N., Thomas, W.B., Lee, A.G. (2015). Chiasmal Disorders. In: Schmidt-Erfurth, U., Kohnen, T. (eds) Encyclopedia of Ophthalmology. Springer, Berlin, Heidelberg.

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