Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

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

Uvelius, Erik LU ; Valdemarsson, Stig LU ; Bengzon, Johan LU ; Hammar, Björn LU and Siesjö, Peter LU orcid (2023) In Brain and Spine 3.
Abstract

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... (More)

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.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Pituitary adenoma, Pituitary neoplasms, Transsphenoidal surgery, Treatment outcome, Visual function
in
Brain and Spine
volume
3
article number
102667
publisher
Elsevier
external identifiers
  • pmid:38020979
  • scopus:85169064411
ISSN
2772-5294
DOI
10.1016/j.bas.2023.102667
language
English
LU publication?
yes
id
a8a59f6e-952c-47ce-86b0-fcaee7a48150
date added to LUP
2023-12-01 13:07:31
date last changed
2024-06-23 20:02:58
@article{a8a59f6e-952c-47ce-86b0-fcaee7a48150,
  abstract     = {{<p>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.</p>}},
  author       = {{Uvelius, Erik and Valdemarsson, Stig and Bengzon, Johan and Hammar, Björn and Siesjö, Peter}},
  issn         = {{2772-5294}},
  keywords     = {{Pituitary adenoma; Pituitary neoplasms; Transsphenoidal surgery; Treatment outcome; Visual function}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Brain and Spine}},
  title        = {{Visual acuity in patients with non-functioning pituitary adenoma : Prognostic factors and long-term outcome after surgery}},
  url          = {{http://dx.doi.org/10.1016/j.bas.2023.102667}},
  doi          = {{10.1016/j.bas.2023.102667}},
  volume       = {{3}},
  year         = {{2023}},
}