J Korean Ophthalmol Soc > Volume 52(6); 2011 > Article
Journal of the Korean Ophthalmological Society 2011;52(6):726-733.
DOI: https://doi.org/10.3341/jkos.2011.52.6.726    Published online June 15, 2011.
Postoperative Visual Field Outcomes in Patients Showing Visual Field Defects due to Pituitary Adenoma.
Chan Hee Moon, Sun Chul Hwang, Tae Kwann Park
1Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Korea. genophilus@hanmail.net
2Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Korea.
시야 결손이 있는 뇌하수체샘종 환자에서 수술 후 시야 변화
문찬희1⋅황선철2⋅박태관1
Departments of Ophthalmology1 and Neurosurgery2, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Korea
Abstract
PURPOSE
To evaluate visual field (VF) changes in patients with pituitary adenoma after surgical treatment. METHODS: The present study retrospectively evaluated 96 eyes of 48 patients with pituitary adenoma who received surgical tumor removal between July 2001 and February 2010. Preoperative and postoperative clinical data including age, tumor volume, logMAR BCVA, surgical technique (transsphenoidal surgery and transcranial surgery), static perimetry scores (mean deviation [MD], pattern standard deviation [PSD], and visual field defect [VFD] scores) were reviewed. RESULTS: The MD (15.79%, p = 0.001) and PSD (3.98%, p = 0.003) improved postoperatively (mean postoperative follow-up period 1.85 months). Transsphenoidal surgery for tumor removal showed significant MD (26.99%, p = 0.000) and PSD (12.92%, p = 0.003) improvements. A multivariate regression analysis of the transsphenoidal surgery patient group revealed that the preoperative MD was related to the postoperative MD (Pearson = 0.762, p = 0.000), but negatively correlated to the amount of postoperative improvement in MD score (Pearson = -0.231, p = 0.046). Transcranial surgery did not significantly improve the MD (p = 0.419), PSD (p = 0.562), VFD score (p = 0.135), or logMAR BCVA (p = 0.708). CONCLUSIONS: Visual filed defects in patients with pituitary adenoma improved after neurosurgical treatment. Better postoperative visual field outcomes were achieved in patients who had smaller preoperative visual field defects. Transsphenoidal surgery significantly improved the visual field defects and visual acuity in patients with non-functioning pituitary adenoma, compared to the transcranial surgery patients.
Key Words: Mean deviation;Pattern standard deviation;Pituitary adenoma;Transcranial surgery;Transsphenoidal surgery


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