Atrophy of optic nerve fibres in compression of the chiasm. Degree and distribution of ophthalmoscopic changes.

Chiasmal lesions produce a characteristic form of partial optic atrophy, subtly reflected by objective changes in the peripapillary portion of the retinal nerve fibre layer. The degrees and distributions of these changes were documented by fundus photography in a series of steady state patients with different degrees of chiasmal damage from pituitary adenoma. Semi-quantitative analysis disclosed a close correspondence with the degree of functional deficit. The state of the retinal nerve fibre layer can therefore be used as an objective indicator of the occurrence and severity of anatomical, chiasmal damage.