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Published in: Pituitary 4/2019

01-08-2019 | Pituitary Adenoma

Preoperative visual evoked potential in the prediction of visual outcome after pituitary macroadenomas surgery

Authors: Mohammad Taghvaei, Seyed Mousa Sadrehosseini, Nima Ostadrahimi, Payam Sarraf, Mehdi Zeinalizadeh

Published in: Pituitary | Issue 4/2019

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Abstract

Objective

The purpose of the present study is to investigate longitudinal changes in Visual evoked potential (VEP) parameters as an objective test after transsphenoidal surgery, its correlation with subjective tests and clinical value of VEP in the prediction of visual outcome.

Methods

Fifty patients with pituitary macroadenoma who underwent surgical removal of the tumor recruited in this study. All the patients underwent ophthalmic examination, static automated perimetry (SAP), VEP and magnetic resonance imaging (MRI) preoperatively and 3 months after surgery.

Results

Fifty patients with pituitary macroadenoma (size: 25.1 ± 9.9 mm) were recruited in the study. Before surgery, the pattern of VEP showed a prolonged latency with reduced amplitude in eyes with abnormal visual acuity or abnormal visual field. The P100 wave latencies and amplitudes showed significant correlation with visual acuity and SAP scores. After surgery, visual acuity and visual field improvements were seen in 51% and 65.6% of eyes, respectively. Mean SAP and visual acuity scores increased significantly (p < 0.01), P100 wave latency declined and amplitude improved after surgery but not significantly. The mean age of patients, size of tumors and preoperative P100 wave latency were significantly lower in eyes with visual field and acuity improvement.

Conclusion

VEP is a helpful quantitative and objective complementary test to visual acuity and SAP exams for assessing pre-operative visual abnormalities and post-operative visual outcome in patients with pituitary macroadenoma.
Literature
1.
2.
go back to reference Hornyak M, Digre K, Couldwell WT (2009) Neuro-ophthalmologic manifestations of benign anterior skull base lesions. Postgrad Med 121(4):103–114CrossRefPubMed Hornyak M, Digre K, Couldwell WT (2009) Neuro-ophthalmologic manifestations of benign anterior skull base lesions. Postgrad Med 121(4):103–114CrossRefPubMed
3.
go back to reference Kivelä T, Pelkonen R, Oja M, Heiskanen O (1998) Diabetes insipidus and blindness caused by a suprasellar tumor: Pieter Pauw’s observations from the 16th century. JAMA 279(1):48–50CrossRefPubMed Kivelä T, Pelkonen R, Oja M, Heiskanen O (1998) Diabetes insipidus and blindness caused by a suprasellar tumor: Pieter Pauw’s observations from the 16th century. JAMA 279(1):48–50CrossRefPubMed
4.
go back to reference Yang EB, Hood DC, Rodarte C, Zhang X, Odel JG, Behrens MM (2007) Improvement in conduction velocity after optic neuritis measured with the multifocal VEP. Invest Ophthalmol Vis Sci 48(2):692–698CrossRefPubMed Yang EB, Hood DC, Rodarte C, Zhang X, Odel JG, Behrens MM (2007) Improvement in conduction velocity after optic neuritis measured with the multifocal VEP. Invest Ophthalmol Vis Sci 48(2):692–698CrossRefPubMed
5.
go back to reference Klistorner A, Graham S, Fraser C, Garrick R, Nguyen T, Paine M, O’Day J, Grigg J, Arvind H, Billson FA (2007) Electrophysiological evidence for heterogeneity of lesions in optic neuritis. Invest Ophthalmol Vis Sci 48(10):4549–4556CrossRefPubMed Klistorner A, Graham S, Fraser C, Garrick R, Nguyen T, Paine M, O’Day J, Grigg J, Arvind H, Billson FA (2007) Electrophysiological evidence for heterogeneity of lesions in optic neuritis. Invest Ophthalmol Vis Sci 48(10):4549–4556CrossRefPubMed
6.
go back to reference Gott PS, Weiss MH, Apuzzo M, Van Der Meulen JP (1979) > Checkerboard visual evoked response in evaluation and management of pituitary tumors. Neurosurgery 5(5):553–558CrossRefPubMed Gott PS, Weiss MH, Apuzzo M, Van Der Meulen JP (1979) > Checkerboard visual evoked response in evaluation and management of pituitary tumors. Neurosurgery 5(5):553–558CrossRefPubMed
7.
go back to reference Petersen J (1984) Objective determination of visual acuity by visual evoked potentials. Spec Tests Vis Funct 9:108–114 Petersen J (1984) Objective determination of visual acuity by visual evoked potentials. Spec Tests Vis Funct 9:108–114
8.
go back to reference Feinsod M, Selhorst JB, Hoyt WF, Wilson CB (1976) Monitoring optic nerve function during craniotomy. J Neurosurg 44(1):29–31CrossRefPubMed Feinsod M, Selhorst JB, Hoyt WF, Wilson CB (1976) Monitoring optic nerve function during craniotomy. J Neurosurg 44(1):29–31CrossRefPubMed
9.
go back to reference Wilson W, Kirsch W, Neville H, Stears J, Feinsod M, Lehman R (1976) Monitoring of visual function during parasellar surgery. Surg Neurol 5(6):323–329PubMed Wilson W, Kirsch W, Neville H, Stears J, Feinsod M, Lehman R (1976) Monitoring of visual function during parasellar surgery. Surg Neurol 5(6):323–329PubMed
10.
go back to reference Semela L, Hedges TR, Vuong L (2007) Serial multifocal visual evoked potential recordings in compressive optic neuropathy. Ophthalmic Sur Lasers Imaging Retina 38(3):250–253 Semela L, Hedges TR, Vuong L (2007) Serial multifocal visual evoked potential recordings in compressive optic neuropathy. Ophthalmic Sur Lasers Imaging Retina 38(3):250–253
11.
go back to reference Flanagan J, Harding G (1988) Multi-channel visual evoked potentials in early compressive lesions of the chiasm. Doc Ophthalmol 69(3):271–281CrossRefPubMed Flanagan J, Harding G (1988) Multi-channel visual evoked potentials in early compressive lesions of the chiasm. Doc Ophthalmol 69(3):271–281CrossRefPubMed
12.
go back to reference Klistorner A, Arvind H, Garrick R, Graham SL, Paine M, Yiannikas C (2010) Interrelationship of optical coherence tomography and multifocal visual-evoked potentials after optic neuritis. Invest Ophthalmol Vis Sci 51(5):2770–2777CrossRefPubMed Klistorner A, Arvind H, Garrick R, Graham SL, Paine M, Yiannikas C (2010) Interrelationship of optical coherence tomography and multifocal visual-evoked potentials after optic neuritis. Invest Ophthalmol Vis Sci 51(5):2770–2777CrossRefPubMed
13.
go back to reference Laron M, Cheng H, Zhang B, Schiffman JS, Tang RA, Frishman LJ (2010) Comparison of multifocal visual evoked potential, standard automated perimetry and optical coherence tomography in assessing visual pathway in multiple sclerosis patients. Mult Scler J 16(4):412–426CrossRef Laron M, Cheng H, Zhang B, Schiffman JS, Tang RA, Frishman LJ (2010) Comparison of multifocal visual evoked potential, standard automated perimetry and optical coherence tomography in assessing visual pathway in multiple sclerosis patients. Mult Scler J 16(4):412–426CrossRef
14.
go back to reference Sriram P, Wang C, Yiannikas C, Garrick R, Barnett M, Parratt J, Graham SL, Arvind H, Klistorner A (2014) Relationship between optical coherence tomography and electrophysiology of the visual pathway in non-optic neuritis eyes of multiple sclerosis patients. PLoS ONE 9(8):e102546CrossRefPubMedPubMedCentral Sriram P, Wang C, Yiannikas C, Garrick R, Barnett M, Parratt J, Graham SL, Arvind H, Klistorner A (2014) Relationship between optical coherence tomography and electrophysiology of the visual pathway in non-optic neuritis eyes of multiple sclerosis patients. PLoS ONE 9(8):e102546CrossRefPubMedPubMedCentral
15.
go back to reference Qiao N, Ye Z, Shou X, Wang Y, Li S, Wang M, Zhao Y (2016) Discrepancy between structural and functional visual recovery in patients after trans-sphenoidal pituitary adenoma resection. Clin Neurol Neurosurg 151:9–17CrossRefPubMed Qiao N, Ye Z, Shou X, Wang Y, Li S, Wang M, Zhao Y (2016) Discrepancy between structural and functional visual recovery in patients after trans-sphenoidal pituitary adenoma resection. Clin Neurol Neurosurg 151:9–17CrossRefPubMed
16.
go back to reference Hood DC, Odel JG, Zhang X (2000) Tracking the recovery of local optic nerve function after optic neuritis: a multifocal VEP study. Invest Ophthalmol Vis Sci 41(12):4032–4038PubMed Hood DC, Odel JG, Zhang X (2000) Tracking the recovery of local optic nerve function after optic neuritis: a multifocal VEP study. Invest Ophthalmol Vis Sci 41(12):4032–4038PubMed
17.
go back to reference Qiao N, Zhang Y, Ye Z, Shen M, Shou X, Wang Y, Li S, Wang M, Zhao Y (2015) Comparison of multifocal visual evoked potential, static automated perimetry, and optical coherence tomography findings for assessing visual pathways in patients with pituitary adenomas. Pituitary 18(5):598–603CrossRefPubMed Qiao N, Zhang Y, Ye Z, Shen M, Shou X, Wang Y, Li S, Wang M, Zhao Y (2015) Comparison of multifocal visual evoked potential, static automated perimetry, and optical coherence tomography findings for assessing visual pathways in patients with pituitary adenomas. Pituitary 18(5):598–603CrossRefPubMed
18.
go back to reference Jayaraman M, Ambika S, Gandhi RA, Bassi SR, Ravi P, Sen P (2010) Multifocal visual evoked potential recordings in compressive optic neuropathy secondary to pituitary adenoma. Doc Ophthalmol 121(3):197–204CrossRefPubMed Jayaraman M, Ambika S, Gandhi RA, Bassi SR, Ravi P, Sen P (2010) Multifocal visual evoked potential recordings in compressive optic neuropathy secondary to pituitary adenoma. Doc Ophthalmol 121(3):197–204CrossRefPubMed
19.
go back to reference Watanabe K, Shinoda K, Kimura I, Mashima Y, Oguchi Y, Ohde H (2007) Discordance between subjective perimetric visual fields and objective multifocal visual evoked potential-determined visual fields in patients with hemianopsia. Am J Ophthalmol 143(2):295.e293–304.e293CrossRef Watanabe K, Shinoda K, Kimura I, Mashima Y, Oguchi Y, Ohde H (2007) Discordance between subjective perimetric visual fields and objective multifocal visual evoked potential-determined visual fields in patients with hemianopsia. Am J Ophthalmol 143(2):295.e293–304.e293CrossRef
20.
go back to reference Holder GE, Bullock PR (1989) Visual evoked potentials in the assessment of patients with non-functioning chromophobe adenomas. J Neurol Neurosurg Psychiatry 52(1):31–37CrossRefPubMedPubMedCentral Holder GE, Bullock PR (1989) Visual evoked potentials in the assessment of patients with non-functioning chromophobe adenomas. J Neurol Neurosurg Psychiatry 52(1):31–37CrossRefPubMedPubMedCentral
21.
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):813–820CrossRefPubMed 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):813–820CrossRefPubMed
22.
go back to reference Anik I, Anik Y, Koc K, Ceylan S, Genc H, Altintas O, Ozdamar D, Ceylan DB (2011) Evaluation of early visual recovery in pituitary macroadenomas after endoscopic endonasal transphenoidal surgery: quantitative assessment with diffusion tensor imaging (DTI). Acta Neurochir 153(4):831–842CrossRefPubMed Anik I, Anik Y, Koc K, Ceylan S, Genc H, Altintas O, Ozdamar D, Ceylan DB (2011) Evaluation of early visual recovery in pituitary macroadenomas after endoscopic endonasal transphenoidal surgery: quantitative assessment with diffusion tensor imaging (DTI). Acta Neurochir 153(4):831–842CrossRefPubMed
23.
go back to reference Barzaghi LR, Medone M, Losa M, Bianchi S, Giovanelli M, Mortini P (2012) Prognostic factors of visual field improvement after trans-sphenoidal approach for pituitary macroadenomas: review of the literature and analysis by quantitative method. Neurosurg Rev 35(3):369–379CrossRefPubMed Barzaghi LR, Medone M, Losa M, Bianchi S, Giovanelli M, Mortini P (2012) Prognostic factors of visual field improvement after trans-sphenoidal approach for pituitary macroadenomas: review of the literature and analysis by quantitative method. Neurosurg Rev 35(3):369–379CrossRefPubMed
24.
go back to reference Thotakura AK, Patibandla MR, Panigrahi MK, Addagada GC (2017) Predictors of visual outcome with transsphenoidal excision of pituitary adenomas having suprasellar extension: a prospective series of 100 cases and brief review of the literature. Asian J Neurosurg 12(1):1CrossRefPubMedPubMedCentral Thotakura AK, Patibandla MR, Panigrahi MK, Addagada GC (2017) Predictors of visual outcome with transsphenoidal excision of pituitary adenomas having suprasellar extension: a prospective series of 100 cases and brief review of the literature. Asian J Neurosurg 12(1):1CrossRefPubMedPubMedCentral
25.
go back to reference Yu F-F, Chen L-L, Su Y-H, Huo L-H, Lin X-X, Liao R-D (2015) Factors influencing improvement of visual field after trans-sphenoidal resection of pituitary macroadenomas: a retrospective cohort study. Int J Ophthalmol 8(6):1224PubMedPubMedCentral Yu F-F, Chen L-L, Su Y-H, Huo L-H, Lin X-X, Liao R-D (2015) Factors influencing improvement of visual field after trans-sphenoidal resection of pituitary macroadenomas: a retrospective cohort study. Int J Ophthalmol 8(6):1224PubMedPubMedCentral
26.
go back to reference Ahmed AH, Giri J, Kashyap R, Singh B, Dong Y, Kilickaya O, Erwin PJ, Murad MH, Pickering BW (2015) Outcome of adverse events and medical errors in the intensive care unit: a systematic review and meta-analysis. Am J Med Qual 30(1):23–30CrossRefPubMed Ahmed AH, Giri J, Kashyap R, Singh B, Dong Y, Kilickaya O, Erwin PJ, Murad MH, Pickering BW (2015) Outcome of adverse events and medical errors in the intensive care unit: a systematic review and meta-analysis. Am J Med Qual 30(1):23–30CrossRefPubMed
27.
go back to reference Zhan R, Ma Z, Wang D, Li X (2015) Pure endoscopic endonasal transsphenoidal approach for nonfunctioning pituitary adenomas in the elderly: surgical outcomes and complications in 158 patients. World Neurosurg 84(6):1572–1578CrossRefPubMed Zhan R, Ma Z, Wang D, Li X (2015) Pure endoscopic endonasal transsphenoidal approach for nonfunctioning pituitary adenomas in the elderly: surgical outcomes and complications in 158 patients. World Neurosurg 84(6):1572–1578CrossRefPubMed
28.
go back to reference Danesh-Meyer HV, Wong A, Papchenko T, Matheos K, Stylli S, Nichols A, Frampton C, Daniell M, Savino PJ, Kaye AH (2015) Optical coherence tomography predicts visual outcome for pituitary tumors. J Clin Neurosci 22(7):1098–1104CrossRefPubMed Danesh-Meyer HV, Wong A, Papchenko T, Matheos K, Stylli S, Nichols A, Frampton C, Daniell M, Savino PJ, Kaye AH (2015) Optical coherence tomography predicts visual outcome for pituitary tumors. J Clin Neurosci 22(7):1098–1104CrossRefPubMed
29.
go back to reference Jacob M, Raverot G, Jouanneau E, Borson-Chazot F, Perrin G, Rabilloud M, Tilikete C, Bernard M, Vighetto A (2009) Predicting visual outcome after treatment of pituitary adenomas with optical coherence tomography. Am J Ophthalmol 147(1):64.e62–70.e62CrossRef Jacob M, Raverot G, Jouanneau E, Borson-Chazot F, Perrin G, Rabilloud M, Tilikete C, Bernard M, Vighetto A (2009) Predicting visual outcome after treatment of pituitary adenomas with optical coherence tomography. Am J Ophthalmol 147(1):64.e62–70.e62CrossRef
30.
go back to reference Moon CH, Hwang SC, Ohn Y-H, Park TK (2011) The time course of visual field recovery and changes of retinal ganglion cells after optic chiasmal decompression. Invest Ophthalmol Vis Sci 52(11):7966–7973CrossRefPubMed Moon CH, Hwang SC, Ohn Y-H, Park TK (2011) The time course of visual field recovery and changes of retinal ganglion cells after optic chiasmal decompression. Invest Ophthalmol Vis Sci 52(11):7966–7973CrossRefPubMed
31.
go back to reference Lachowicz E, Lubiński W (2018) The importance of the electrophysiological tests in the early diagnosis of ganglion cells and/or optic nerve dysfunction coexisting with pituitary adenoma: an overview. Doc Ophthalmol 137(3):193–202CrossRefPubMedPubMedCentral Lachowicz E, Lubiński W (2018) The importance of the electrophysiological tests in the early diagnosis of ganglion cells and/or optic nerve dysfunction coexisting with pituitary adenoma: an overview. Doc Ophthalmol 137(3):193–202CrossRefPubMedPubMedCentral
Metadata
Title
Preoperative visual evoked potential in the prediction of visual outcome after pituitary macroadenomas surgery
Authors
Mohammad Taghvaei
Seyed Mousa Sadrehosseini
Nima Ostadrahimi
Payam Sarraf
Mehdi Zeinalizadeh
Publication date
01-08-2019
Publisher
Springer US
Published in
Pituitary / Issue 4/2019
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-019-00969-5

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