| 본문 : In contrast to bitemporal hemianopia, binasal hemianopia is rarely reported in association with an intracranial lesion. We present the case of a 24-year-old male patient with pneumosinus dilatans of the sphenoid sinus, who presented with binasal hemianopia at the initial presentation.
A 24-year-old male presented to our clinic with bilateral visual disturbance that was gradually worsening for several months. There was no previous history of systemic diseases, ocular trauma, or regular medication. He had experienced intermittent mild headaches in the frontal area previously. The best-corrected visual acuity was 20/100 in both eyes, and the refractive error was -600 +2.50 D x 90 in the right eye and -6.00 +2.00 D x 90 in the left eye. The pupil showed a normal response to light and near stimulation in both eyes. The color vision test using the Ishihara plate showed normal results. There were no ocular motility deficits. The fundoscopic exam showed normal finding of optic discs in both eyes. The automated perimetry (Humphrey field analyzer, Carl Zeiss Meditec, Inc., Dublin, USA) demonstrated binasal hemianopia. The repeated visual field test performed 2 weeks later showed the same result. The electrophysiologic study performed at another clinic showed normal results. The peripapillary retinal nerve fiber layer thickness, measured using optical coherence tomography, was within normal limits. Magnetic resonance imaging of the brain revealed extensively pneumatized and enlarged ethmoid and sphenoid sinuses. The intracanalicular portion of the optic nerve was compressed in the temporal region by the enlarged sphenoid sinuses in each eye. The patient was referred to the otorhinolaryngology department for surgical compression; however, he refused the surgical procedure and did not return for follow-up visits. |