Vol 6 (2021): Continuous Publishing
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Published online: 2021-12-30

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Visual outcomes after endoscopic pituitary adenomas surgery: our experience

Carla Fernandes1, Lídia Nunes Dias2, Tiago Lorga3, Pedro Arede1, João Costa1
Ophthalmol J 2021;6:241-244.

Abstract

Background: Pituitary adenomas are the most common cause of sellar tumors after the third decade of life. They can lead to visual impairment due to a close anatomical relationship with the optic chiasm. The purpose of this study is to evaluate visual outcomes after endoscopic pituitary adenoma surgery in patients from Egas Moniz hospital between January 2013 and August 2020.

Material and methods: Patients with pituitary adenoma with pre- and post-surgical ophthalmological evaluation were retrospectively included. Pre- and post-surgical visual parameters, clinical, imaging, histological, and surgical data were selected, and a descriptive analysis was performed. Pre- and post-surgical visual parameters were compared using Statistical Package for the Social Sciences (SPSS). Improvement criteria were defined: pre-surgical visual complaints > post-surgical visual complaints; visual acuity (VA) (LogMAR) pre-surgical > VA (LogMAR) post-surgical; pre-surgical chromatic vision > post-surgical chromatic vision; visual field mean sensitivity (MS) post-surgical > visual field MS pre-surgical + 1; visual field temporal mean sensitivity (MST) post-surgical > visual field MST pre-surgical + 1; visual field nasal mean sensitivity (MSN) post-surgical > visual field MSN pre-surgical + 1.

Results and Discussion: Of the total 18 patients included, 11 (68.8%) fulfilled all improvement criteria, and 14 (82.4%) fulfilled at least one. These results go with the current scientific evidence that pituitary adenoma resection in patients with pre-surgical visual symptoms considerably improves these symptoms.

Conclusion: Standardization of visual evaluation may be a key point to identify prognostic factors for visual function
recovery after surgery.

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