Neuro-ophthalmology of Sellar Disease

The degree to which a patient with sellar pathology has been neurologically affected by the lesion can be best determined with a neuro-ophthalmic examination, which traditionally includes a detailed historical assessment and physical examination. With lesions in the sellar region, the clinical neuro-ophthalmologic examination often reveals neural dysfunction because several important afferent and efferent visual pathways course near this area. The combination of neuroradiological, neuroendocrinological, and neuro-ophthalmological assessment is needed to properly manage the typical patient with a parasellar lesion. This chapter will provide an overview of the relevant anatomy and clinical neuro-ophthalmic features of lesions that affect the sellar region.