open access

Vol 6 (2021): Continuous Publishing
Original paper
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.
Affiliations
  1. Serviço de Oftalmologia Hospital de Egas Moniz, CHLO, Lisboa, Portugal
  2. Serviço de Neurocirurgia Hospital de Egas Moniz, CHLO, Lisboa, Portugal
  3. Serviço de Neurorradiologia Hospital de Egas Moniz, CHLO, Lisboa, Portugal

open access

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

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.

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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Keywords

pituitary adenomas; endoscopic surgery; visual function

About this article
Title

Visual outcomes after endoscopic pituitary adenomas surgery: our experience

Journal

Ophthalmology Journal

Issue

Vol 6 (2021): Continuous Publishing

Article type

Original paper

Pages

241-244

Published online

2021-12-30

Page views

5685

Article views/downloads

518

DOI

10.5603/OJ.2021.0039

Bibliographic record

Ophthalmol J 2021;6:241-244.

Keywords

pituitary adenomas
endoscopic surgery
visual function

Authors

Carla Fernandes
Lídia Nunes Dias
Tiago Lorga
Pedro Arede
João Costa

References (7)
  1. Snyder R, Fayed I, Dowlati E, et al. Pituitary Adenoma and Craniopharyngioma Collision Tumor: Diagnostic, Treatment Considerations, and Review of the Literature. World Neurosurg. 2019; 121: 211–216.
  2. Lee DK, Sung MiS, Park SW. Factors Influencing Visual Field Recovery after Transsphenoidal Resection of a Pituitary Adenoma. Korean J Ophthalmol. 2018; 32(6): 488–496.
  3. Fredes F, Undurraga G, Rojas P, et al. Visual Outcomes after Endoscopic Pituitary Surgery in Patients Presenting with Preoperative Visual Deficits. J Neurol Surg B Skull Base. 2017; 78(6): 461–465.
  4. Kerrison JB, Lynn MJ, Baer CA, et al. Stages of improvement in visual fields after pituitary tumor resection. Am J Ophthalmol. 2000; 130(6): 813–820.
  5. Uy B, Wilson B, Kim WiJ, et al. Visual Outcomes After Pituitary Surgery. Neurosurg Clin N Am. 2019; 30(4): 483–489.
  6. Shen M, Chen Z, Shou X, et al. Surgical Outcomes and Predictors of Visual Function Alterations After Transcranial Surgery for Large-to-Giant Pituitary Adenomas. World Neurosurg. 2020; 141: e60–e69.
  7. Muskens IS, Zamanipoor Najafabadi AH, Briceno V, et al. Visual outcomes after endoscopic endonasal pituitary adenoma resection: a systematic review and meta-analysis. Pituitary. 2017; 20(5): 539–552.

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