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Visual loss in a patient with primary empty sella. Case report.

To the Editor. —The empty sella is an acquired anatomic condition in which the subarachnoid space protrudes into the cavity of the sella turcica and the pituitary gland is flattened against the sellar floor or walls. Cases not associated with prior pituitary irradiation or surgery are termed primary. Although most patients with primary empty sella have normal vision, a sizable minority show some degree of visual compromise. We describe herein a case of primary empty sella associated with visual loss in which the clinical and radiographic findings suggest the mechanism responsible for damage to the visual pathways. Report of a Case. —A 38-year-old obese black woman stated that she experienced visual loss in both eyes two years previously. No further change in vision had been noted since then. On examination, her visual acuity was 20/30 OD and 20/40 OS. Both optic discs were pale. Visual fields showed a superotemporal defect