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Björn Hammar, MD, PhD. Photo.

Björn Hammar

Specialist physician

Björn Hammar, MD, PhD. Photo.

Visual acuity in patients with non-functioning pituitary adenoma : Prognostic factors and long-term outcome after surgery

Author

  • Erik Uvelius
  • Stig Valdemarsson
  • Johan Bengzon
  • Björn Hammar
  • Peter Siesjö

Summary, in English

Background: Visual acuity (VA) and visual field defects (VF) are evaluated in the preoperative management of non-functioning pituitary adenoma (NFPA). The former is less studied than the latter. Research question: To analyze preoperative factors, including adenoma volumetry, associated with reduced VA and postoperative improvement of VA over five years after surgery. Methods: Eighty-seven patients who had primary surgery for NFPA were retrospectively reviewed. Eyes were categorized by best/worse preoperative VA. Ophthalmology review was performed before surgery, at three months, one to two years, and five years post-surgery. Results: Reduced VA in any eye was present in 55%. VA of the worse eye improved in 77% and normalized in 54%. The majority improved within three months. Additional cases with VA improvement were seen at 1–2 years after surgery. No further improvement was seen five years after surgery. Fifty percent of patients with, per definition, normal preoperative VA showed improved VA postoperatively. Tumor height above the sella in the sagittal plane was the best radiological predictor of reduced VA. Volumetry did not add to accuracy. Age, sagittal tumor height and visual field defects were risk factors of preoperative reduced VA. No predictors of postoperative recovery were identified. Conclusion: Half of patients with reduced VA recover fully. All patients, independent of age and degree of VA reduction, may improve. No predictors of recovery were found. Early improvement is common and improvement beyond two years is unlikely. The frequency of reduced VA is underestimated. The present results could be of value in pre- and postoperative counseling.

Department/s

  • Neurosurgery
  • Medicine, Lund
  • Endocrine
  • LUCC: Lund University Cancer Centre
  • Epilepsy Center
  • StemTherapy: National Initiative on Stem Cells for Regenerative Therapy
  • Ophthalmology Imaging Research Group
  • Clinical research in neuro-ophthalmology
  • Ophthalmology, Lund
  • Glioma immunotherapy group

Publishing year

2023-01

Language

English

Publication/Series

Brain and Spine

Volume

3

Document type

Journal article

Publisher

Elsevier

Topic

  • Surgery

Keywords

  • Pituitary adenoma
  • Pituitary neoplasms
  • Transsphenoidal surgery
  • Treatment outcome
  • Visual function

Status

Published

Research group

  • Endocrine
  • Ophthalmology Imaging Research Group
  • Clinical research in neuro-ophthalmology
  • Glioma immunotherapy group

ISBN/ISSN/Other

  • ISSN: 2772-5294