Hyperpituitarism refers to excess production of one or more pituitary hormones, often due to an adenoma. Large pituitary tumours can affect vision.
Ocular and systemic effects
Compression of the optic chiasm is a key concern.
- Bitemporal visual field loss and reduced acuity in advanced cases
- Headaches and sometimes double vision from cranial nerve involvement
- Hormonal syndromes such as acromegaly, Cushing disease, or hyperprolactinaemia
- MRI confirms pituitary enlargement and relationship to the chiasm
Management
Treatment depends on tumour type and size.
- Medical therapy such as dopamine agonists for prolactinomas
- Transsphenoidal surgery and/or radiotherapy for other functioning adenomas
- Regular visual field testing and endocrine follow-up
- Hormone replacement if hypopituitarism occurs after treatment
