Chistyakova S.V., Каiotkina E.V.
MODERN OPHTHALMODIAGNOSIS POSSIBLE EARLY MANIFESTATIONS OF HYPERPROLACTINEMIA IN WOMEN ^{[№ 12 ' 2015]}
It is generally recognized that a sign of hyperprolactinemia (GPRL), is to increase the levels of the hormone prolactin (PRL). There is a dissonance between the level of PRL in the serum and the severity of ocular manifestations, and significantly complicates early diagnosis and prognosis of the disease. Given the nature of the location of the intracranial optic nerves, crossed them in the chiasm and settling near the pituitary gland, so functional and organic changes may affect the functions of the visual analyzer. A total of 82 women (164 eyes) aged from 16 to 36 years old, the average age was 26,1±2,3 years. A survey of patients included: clinical, gynecological, ophthalmological examinations. According to the results of computer Humphrey perimetry reduction of the threshold of sensitivity in the upper-nasal areas identified in 10 (12.2 %) women, bitemporal hemianopsia in 71 (86.5 %) cases, unilateral temporal decrease — in 1 (1.3 %) case. When Goldmann perimetry no patient showed no limitation of the visual fields. When R-graphy sella retrosellyarnoe calcification was detected in 3 (3.6 %) women. When CTG and MRI of the brain revealed — prolactinoma in 22 (26.8 %), external hydrocephalus — in 7 (8.5 %) cases. In 15 women were diagnosed with hypothalamic-pituitary syndrome, which in 7 (8.5 %) cases accompanied by changes in thyroid function. Treatment of hormone imbalance to assign the drug Dostinex (intended gynecologist). It was found that patients with hyperprolactinemia most significant finding — Humphrey perimetry. In 86.4 % of cases it was found to decrease in retinal sensitivity characteristic that has made the highest accuracy of the method compared to the R-graphy sella (13.6 %). The important symptoms of pituitary prolactinomas are the progression of myopia in the age > 20 years (27.3 %), the presence of the syndrome of "dry eye" (100 % of patients). Modern ophthalmologic diagnosis of hyperprolactinemia is the earliest diagnostic criteria to identify and follow-up.