Skip to main content
Top
Published in: Pituitary 1/2007

Open Access 01-03-2007

Progressive improvement of impaired visual acuity during the first year after transsphenoidal surgery for non-functioning pituitary macroadenoma

Authors: O. M. Dekkers, R. J. W. de Keizer, F. Roelfsema, A. A. vd Klaauw, P. J. Honkoop, H. van Dulken, J. W. A. Smit, J. A. Romijn, A. M. Pereira

Published in: Pituitary | Issue 1/2007

Login to get access

Abstract

Objective

Improvement of visual field defects continues even years after the initial surgical treatment. Because this process of continuing improvement has not been documented for visual acuity, we audited our data to explore the pattern of recovery of visual acuity until 1 year after transsphenoidal surgery for non-functioning pituitary macroadenoma.

Design

Retrospective follow-up study.

Patients

Forty-three patients (mean age 56 ± 14 years), treated by transsphenoidal surgery for non-functioning pituitary macroadenoma, were included in this analysis.

Results

Visual acuity improved significantly within 3 months after transsphenoidal surgery. The mean visual acuity increased from 0.65 ± 0.37 to 0.75 ± 0.36 (P < 0.01) (right eye), and from 0.60 ± 0.32 to 0.82 ± 0.30 (P < 0.01) (left eye). Visual acuity was improved 1 year after transsphenoidal surgery compared to the 3 months postoperative values. The mean visual acuity increased from 0.75 ± 0.36 to 0.82 ± 0.34 (P < 0.05) (right eye), and from 0.82 ± 0.30 to 0.88 ± 0.27 (P < 0.05) (left eye).

Conclusion

Visual acuity improves progressively after surgical treatment for non-functioning pituitary macroadenomas, at least within the first year after transsphenoidal surgery.
Literature
1.
go back to reference Feldkamp J, Santen R, Harms E, Aulich A, Modder U, Scherbaum WA (1999) Incidentally discovered pituitary lesions: high frequency of macroadenomas and hormone-secreting adenomas—results of a prospective study. Clin Endocrinol (Oxf) 51(1):109–113CrossRef Feldkamp J, Santen R, Harms E, Aulich A, Modder U, Scherbaum WA (1999) Incidentally discovered pituitary lesions: high frequency of macroadenomas and hormone-secreting adenomas—results of a prospective study. Clin Endocrinol (Oxf) 51(1):109–113CrossRef
2.
go back to reference McComb DJ, Ryan N, Horvath E, Kovacs K (1983) Subclinical adenomas of the human pituitary. New light on old problems. Arch Pathol Lab Med 107(9):488–491PubMed McComb DJ, Ryan N, Horvath E, Kovacs K (1983) Subclinical adenomas of the human pituitary. New light on old problems. Arch Pathol Lab Med 107(9):488–491PubMed
3.
go back to reference Comtois R, Beauregard H, Somma M, Serri O, Aris-Jilwan N, Hardy J (1991) The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer 68(4):860–866PubMedCrossRef Comtois R, Beauregard H, Somma M, Serri O, Aris-Jilwan N, Hardy J (1991) The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer 68(4):860–866PubMedCrossRef
4.
go back to reference Dekkers OM, Pereira AM, Roelfsema F et al (2006) Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 91(5):1796–1801PubMedCrossRef Dekkers OM, Pereira AM, Roelfsema F et al (2006) Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 91(5):1796–1801PubMedCrossRef
5.
go back to reference Ebersold MJ, Quast LM, Laws ER Jr, Scheithauer B, Randall RV (1986) Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas. J Neurosurg 64(5):713–719PubMedCrossRef Ebersold MJ, Quast LM, Laws ER Jr, Scheithauer B, Randall RV (1986) Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas. J Neurosurg 64(5):713–719PubMedCrossRef
6.
go back to reference Powell M (1995) Recovery of vision following transsphenoidal surgery for pituitary adenomas. Br J Neurosurg 9(3):367–373PubMedCrossRef Powell M (1995) Recovery of vision following transsphenoidal surgery for pituitary adenomas. Br J Neurosurg 9(3):367–373PubMedCrossRef
7.
go back to reference Peter M, De Tribolet N (1995) Visual outcome after transsphenoidal surgery for pituitary adenomas. Br J Neurosurg 9(2):151–157PubMedCrossRef Peter M, De Tribolet N (1995) Visual outcome after transsphenoidal surgery for pituitary adenomas. Br J Neurosurg 9(2):151–157PubMedCrossRef
8.
go back to reference Zhang X, Fei Z, Zhang J et al (1999) Management of nonfunctioning pituitary adenomas with suprasellar extensions by transsphenoidal microsurgery. Surg Neurol 52(4):380–385PubMedCrossRef Zhang X, Fei Z, Zhang J et al (1999) Management of nonfunctioning pituitary adenomas with suprasellar extensions by transsphenoidal microsurgery. Surg Neurol 52(4):380–385PubMedCrossRef
9.
go back to reference Cohen AR, Cooper PR, Kupersmith MJ, Flamm ES, Ransohoff J (1985) Visual recovery after transsphenoidal removal of pituitary adenomas. Neurosurgery 17(3):446–452PubMedCrossRef Cohen AR, Cooper PR, Kupersmith MJ, Flamm ES, Ransohoff J (1985) Visual recovery after transsphenoidal removal of pituitary adenomas. Neurosurgery 17(3):446–452PubMedCrossRef
10.
go back to reference Trautmann JC, Laws ER Jr (1983) Visual status after transsphenoidal surgery at the Mayo Clinic, 1971–1982. Am J Ophthalmol 96(2):200–208PubMed Trautmann JC, Laws ER Jr (1983) Visual status after transsphenoidal surgery at the Mayo Clinic, 1971–1982. Am J Ophthalmol 96(2):200–208PubMed
11.
go back to reference Jakobsson KE, Petruson B, Lindblom B (2002) Dynamics of visual improvement following chiasmal decompression. Quantitative pre- and postoperative observations. Acta Ophthalmol Scand 80(5):512–516PubMedCrossRef Jakobsson KE, Petruson B, Lindblom B (2002) Dynamics of visual improvement following chiasmal decompression. Quantitative pre- and postoperative observations. Acta Ophthalmol Scand 80(5):512–516PubMedCrossRef
12.
go back to reference Kerrison JB, Lynn MJ, Baer CA, Newman SA, Biousse V, Newman NJ (2000) Stages of improvement in visual fields after pituitary tumor resection. Am J Ophthalmol 130(6):813–820PubMedCrossRef Kerrison JB, Lynn MJ, Baer CA, Newman SA, Biousse V, Newman NJ (2000) Stages of improvement in visual fields after pituitary tumor resection. Am J Ophthalmol 130(6):813–820PubMedCrossRef
13.
go back to reference Gnanalingham KK, Bhattacharjee S, Pennington R, Ng J, Mendoza N (2005) The time course of visual field recovery following transphenoidal surgery for pituitary adenomas: predictive factors for a good outcome. J Neurol Neurosurg Psychiatry 76(3):415–419PubMedCrossRef Gnanalingham KK, Bhattacharjee S, Pennington R, Ng J, Mendoza N (2005) The time course of visual field recovery following transphenoidal surgery for pituitary adenomas: predictive factors for a good outcome. J Neurol Neurosurg Psychiatry 76(3):415–419PubMedCrossRef
14.
go back to reference Findlay G, McFadzean RM, Teasdale G (1983) Recovery of vision following treatment of pituitary tumours; application of a new system of assessment to patients treated by transsphenoidal operation. Acta Neurochir (Wien) 68(3–4):175–186CrossRef Findlay G, McFadzean RM, Teasdale G (1983) Recovery of vision following treatment of pituitary tumours; application of a new system of assessment to patients treated by transsphenoidal operation. Acta Neurochir (Wien) 68(3–4):175–186CrossRef
15.
go back to reference Ricci F, Cedrone C, Cerulli L (1998) Standardized measurement of visual acuity. Ophthalmic Epidemiol 5(1):41–53PubMedCrossRef Ricci F, Cedrone C, Cerulli L (1998) Standardized measurement of visual acuity. Ophthalmic Epidemiol 5(1):41–53PubMedCrossRef
16.
go back to reference Kniestedt C, Stamper RL (2003) Visual acuity, its measurement. Ophthalmol Clin North Am 16(2):155–170PubMedCrossRef Kniestedt C, Stamper RL (2003) Visual acuity, its measurement. Ophthalmol Clin North Am 16(2):155–170PubMedCrossRef
17.
go back to reference Hardy J (1979) The transsphenoidal surgical approach to the pituitary. Hosp Pract 14(6):81–89PubMed Hardy J (1979) The transsphenoidal surgical approach to the pituitary. Hosp Pract 14(6):81–89PubMed
18.
go back to reference Clifford-Jones RE, Landon DN, McDonald WI (1980) Remyelination during optic nerve compression. J Neurol Sci 46(2):239–243PubMedCrossRef Clifford-Jones RE, Landon DN, McDonald WI (1980) Remyelination during optic nerve compression. J Neurol Sci 46(2):239–243PubMedCrossRef
19.
go back to reference Clifford-Jones RE, McDonald WI, Landon DN (1985) Chronic optic nerve compression. An experimental study. Brain 108(Pt 1):241–262PubMedCrossRef Clifford-Jones RE, McDonald WI, Landon DN (1985) Chronic optic nerve compression. An experimental study. Brain 108(Pt 1):241–262PubMedCrossRef
20.
go back to reference Smith KJ, Blakemore WF, McDonald WI (1981) The restoration of conduction by central remyelination. Brain 104(2):383–404PubMedCrossRef Smith KJ, Blakemore WF, McDonald WI (1981) The restoration of conduction by central remyelination. Brain 104(2):383–404PubMedCrossRef
21.
go back to reference Smith EJ, Blakemore WF, McDonald WI (1979) Central remyelination restores secure conduction. Nature 280(5721):395–396PubMedCrossRef Smith EJ, Blakemore WF, McDonald WI (1979) Central remyelination restores secure conduction. Nature 280(5721):395–396PubMedCrossRef
22.
go back to reference Williams GP, Pathak-Ray V, Austin MW, Lloyd AP, Millington IM, Bennett A (2006) Quality of life and visual rehabilitation: an observational study of low vision in three general practices in West Glamorgan. Eye 2006 Williams GP, Pathak-Ray V, Austin MW, Lloyd AP, Millington IM, Bennett A (2006) Quality of life and visual rehabilitation: an observational study of low vision in three general practices in West Glamorgan. Eye 2006
23.
go back to reference Klein R, Moss SE, Klein BE, Gutierrez P, Mangione CM (2001) The NEI-VFQ-25 in people with long-term type 1 diabetes mellitus: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch Ophthalmol 119(5):733–740PubMed Klein R, Moss SE, Klein BE, Gutierrez P, Mangione CM (2001) The NEI-VFQ-25 in people with long-term type 1 diabetes mellitus: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch Ophthalmol 119(5):733–740PubMed
24.
go back to reference Movsas B, Movsas TZ, Steinberg SM, Okunieff P (1995) Long-term visual changes following pituitary irradiation. Int J Radiat Oncol Biol Phys 33(3):599–605PubMedCrossRef Movsas B, Movsas TZ, Steinberg SM, Okunieff P (1995) Long-term visual changes following pituitary irradiation. Int J Radiat Oncol Biol Phys 33(3):599–605PubMedCrossRef
Metadata
Title
Progressive improvement of impaired visual acuity during the first year after transsphenoidal surgery for non-functioning pituitary macroadenoma
Authors
O. M. Dekkers
R. J. W. de Keizer
F. Roelfsema
A. A. vd Klaauw
P. J. Honkoop
H. van Dulken
J. W. A. Smit
J. A. Romijn
A. M. Pereira
Publication date
01-03-2007
Published in
Pituitary / Issue 1/2007
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-007-0007-0

Other articles of this Issue 1/2007

Pituitary 1/2007 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.