Prognostic factors of visual field improvement after trans-sphenoidal approach for pituitary macroadenomas: Review of the literature and analysis by quantitative method

Lina Raffaella Barzaghi, Marzia Medone, Marco Losa, Stefania Bianchi, Massimo Giovanelli, Pietro Mortini

Research output: Contribution to journalArticlepeer-review

Abstract

The objective of the study was to evaluate the preoperative visual field defect, the postoperative outcome and the possible prognostic factors in patients with pituitary macroadenoma, using a quantitative method (the mean deviation=MD), and to review the literature. A total of 73 patients, operated trough trans-sphenoidal approach, were selected, and data in single eyes were analysed by calculating the frequency and the degree of postoperative improvement (relative improvement). The visual field defect improved in 95.7% of eyes: The recovery was complete in 48.9% and partial in 46.8%. Multivariate logistic regression showed that factors, independently predictive for complete recovery, were as follows: low preoperative MD absolute value (p=0.008), low craniocaudal diameter of tumour (p=0.02) and young age (p= 0.0001). The mean relative improvement in visual field defect (dMD%) was correlated with the preoperative visual acuity (p=0.0001) and inversely related with the preoperative MD (p=0.007) and the age (p=0.017). The relative improvement was higher in tumours with a smaller craniocaudal diameter (p=0.0185). In conclusion, using a quantitative method, we can measure the degree of the postoperative visual field defect improvement. Predictive factors for a complete recovery were good preoperative visual function, young age and low cranio-caudal tumour.

Original languageEnglish
Pages (from-to)369-378
Number of pages10
JournalNeurosurgical Review
Volume35
Issue number3
DOIs
Publication statusPublished - Jul 2012

Keywords

  • Pituitary adenomas
  • Visual field outcome
  • Visual improvement after trans-sphenoidal surgery
  • Visual outcome

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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