Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 5-6, Pages: 296-303
https://doi.org/10.2298/SARH1306296G
Full text ( 1414 KB)
Cited by
Outcome of visual acuity after surgical removal of pituitary adenomas
Grković Desanka (Klinički centar Vojvodine, Klinika za očne bolesti, Novi Sad)
Bedov Tatjana (Klinički centar Vojvodine, Klinika za očne bolesti, Novi Sad)
Introduction. Pituitary adenomas with suprasellar extension may produce
anterior visual pathway compression, resulting in characteristic visual
deficit. Surgical decompression of these structures prevents further visual
deterioration and its postop erative recovery. Objective. The aim of this
study was to investigate pre and postoperative visual acuity (VA) in
patients with pituitary ad enomas, and to detect the influence of prognostic
factors, such as symptoms duration, degree of visual acuity reduction and
tumor size in the assessment of the prognosis of postoperative visual
function. Methods. We analyzed 40 consecutive patients who fulfilled three
criteria: evidence of preoperative visual dysfunction, transsphenoidal or
transfrontal tumor resection and hystologically verified pituitary adenoma. A
visual examination was performed under standard conditions, pre and
postoperatively (10 days, one month and six months after surgery). A paired
ttest was used to assess the differences of pre and postoperative
characteristics values, and the Chisquare test of independence in the
assessment of the influence of prognostic factors. Results. Postoperative
improvement of VA was seen in 84.61% patients (68% eyes). Eyes with
preoperative mild and moderate degree of VA reduction showed improvement in
89.65% eyes in contrast to 22.60% eyes with preoperative severe reduction of
VA, which was all statistically significant. Eyes in patients with tumor
smaller than 20 mm had improvement of VA in 91.66% eyes, while eyes with
tumor larger than 40 mm had improvement of VA in 61.11% eyes, which was
statistically significant. When symptoms duration was below two years the
improvement of VA was detected in 65.38% eyes as related to 50% eyes with
symptoms duration exceeding two years, which was not statistically
significant. Conclusion. Pituitary adenomas commonly cause visual impairment.
Postoperatively the majority of patients show a distinct improvement of
visual acuity. The degree of preoperative visual loss and tumor size
influence the final visual outcome, and not the duration of symptoms.
Keywords: pituitary adenoma, visual acuity, predictive factors