Purpose: Pituitary macroadenomas with suprasellar extension present tight relationships with optic pathways; only one case of optic nerve penetration by a pituitary adenoma has been reported previously.
Methods: We report two cases of patients suffering from non-functioning pituitary macroadenomas with intra-operative findings of longitudinal splitting of the optic pathways.
Results: In both cases the patients were first operated on by a trans-sphenoidal route and the residual suprasellar tumour was resected by a transcranial surgery.
Conclusion: The patients presented a good visual recovery, suggesting that the splitting of the optic pathways has not jeopardised the functional and anatomical integrity of the optic fibres in the reported cases.