Postoperative visual outcome in nonfunctioning pituitary adenomas
Department of Neurological Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Aim: The effect of surgery alone or in combination with radiotherapy in recovering of visual impairment was evaluated in 86 patients with nonfunctioning pituitary adenoma (NFPA). Methods: In this report 86 patients with NFPA out of 315 cases of pituitary adenoma (all types), who had been operated in Dr. Shariati hospital during 1977-2002, were retrospectively studied. On the basis of the type of surgery, patients were divided into two main groups. Thirty two patients underwent transphenoidal surgery and 54 patients transcranial approach at primary operation. RESULTS: Among these patients, there were 24 female cases (28%) and 62 male patients (72%). The average age was 42.6 years with the range of 13-69 years old (44.7 years in the transsphenoidal and 41.3 years in transcranial operations). Prevalence of visual acuity impairment was 95% in the first group and 88% in the second, while visual field defects were detected in 68% and 75% respectively. The follow up has been from 1 month up to 19 years with a mean of 17.7. Conclusion: Postoperative visual outcome in transphenoidal group was composed of 79% of visual acuity and 70% of visual field improvement without deterioration, compared with 54% of visual acuity improvement versus 13% deterioration and 40% of visual field improvement versus 4% deterioration in transcranial group. In the second group (transcranial operations) 22% of eyes with preoperative normal visual field suffered visual field problem after surgery, while there were no such cases in the transpheniod ones.
Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Nice, France; February 7 - 10, 2004; in poster session 991 (Synergistic therapies).