P-093 Neuro-Ophthalmologic and Endocrine Follow-Up in Patients With Partial Empty Sella Syndrome - A Case Series

Abstract Introduction: Partial empty sella is a radiological finding where the subarachnoid space partially extends into the sella turcica, when associated with endocrine, ophthalmic and neurological conditions and symptoms like idiopathic intracranial hypertension (IIH) and chronic headaches, it is called partial empty sella syndrome. Its clinical significance varies, and diagnostic evaluation can be challenging. Partial empty sella is considered to be relatively uncommon condition; however, its detection has increased in recent years, largely due to improved availability and sensitivity of imaging techniques. These are five times more common in women and more prevalent in obese individuals. Hormonal abnormalities are associated with PES in roughly 40% of affected patients. Although there are no formal guidelines for the management of PES, most experts recommend supportive care for symptomatic patients. If hormonal abnormalities are detected, treatment is individualized to address the specific deficiencies. Regular follow-up is important to monitor for development of any associated conditions in asymptomatic patients. Although clear recommendations are lacking, some experts propose clinical and imaging follow-up every 2 to 3 years or as clinically indicated. We report here two cases of middle-aged women presenting with complains of unilateral headache. One complained of blurry vision. Both denied changes in menstrual cycles, galactorrhoea, or other endocrine symptoms. Neurological examination was unremarkable. MRI brain confirmed partial empty sella with a small CSF-like cyst within the sella in one patient and empty sella with normal ventricular system in another. CSF analysis ruled out subarachnoid haemorrhage and infection. Ophthalmologist ruled out papilledema. Neurologist and neurosurgeon ruled out hydrocephalus. Both the patients remain under regular follow-up for symptom monitoring. These cases highlight the diagnostic complexity of headaches associated with PES, emphasizing the importance of multidisciplinary evaluation to rule out underlying causes such as IIH or occult sellar pathology in similar presentations. Table 1:Endocrine profile