Kerrison J B, Lynn M J, Baer C A, Newman S A, Biousse V, Newman N J
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Am J Ophthalmol. 2000 Dec;130(6):813-20. doi: 10.1016/s0002-9394(00)00539-0.
To use static threshold perimetry to examine the stages of improvement and the potential for late improvement of visual fields after surgical resection of pituitary adenomas causing visual loss from compression of the anterior visual pathways.
Retrospective review of charts of patients with pituitary tumors and abnormal static threshold perimetry before or soon after treatment who had subsequent visual fields. Quantification of the visual field mean deviation overall, superotemporally, and inferotemporally was performed and compared between visits. Postoperative visits were considered in five time periods: visit 1 (surgery to 1 week), visit 2 (1 month to 4 months), visit 3 (6 months to 1 year), visit 4 (2 years), and visit 5 (3 or more years).
Sixty-two patients were included (33 men and 29 women; mean age 54 years [SD +/- 15 years; range, 22 to 83 years]). At visit 1, the relative improvement of the overall mean deviation for the right eye was 30.8% (P =.01) and for the left eye was 13.7% (P =.3067). At visit 2, the relative improvement of the overall mean deviation for the right eye was 30. 4% (P =.0142) and for the left eye was 32.6% (P =.0092). At visits 1 and 2, the inferotemporal quadrants were the quadrants with greatest improvement (visit 1, right eye, 37.8% [P =.0082]; visit 2, left eye, 30.8% [P =.0074]). At visits 3, 4, and 5, an overall trend toward mild improvement was observed with statistical significance only for the inferotemporal quadrant of the left eye from visit 2 to visit 3, which improved 19.7% (P =.0270).
The pattern of recovery of visual function after decompression of the anterior visual pathways suggests at least three phases of improvement. The early fast phase (surgery to 1 week) of improvement may lead to normalization of visual fields in some individuals. The early slow phase (1 month to 4 months) is the period of most notable improvement. A late phase (6 months to 3 years) of mild improvement does not appear significant overall but may be marked in some individuals. Each of these phases may have one or more mechanisms underlying the observed improvement.
运用静态阈值视野检查法，研究因垂体腺瘤压迫前视觉通路导致视力丧失的患者，在手术切除垂体腺瘤后视野改善的阶段以及后期改善的可能性。
回顾性分析垂体肿瘤患者的病历，这些患者在治疗前或治疗后不久进行了静态阈值视野检查且有后续视野检查结果。对每次检查的视野平均偏差进行整体、颞上象限和颞下象限的量化，并比较不同检查之间的差异。术后检查分为五个时间段：第1次检查（手术至1周）、第2次检查（1个月至4个月）、第3次检查（6个月至1年）、第4次检查（2年）和第5次检查（3年或更长时间）。
纳入62例患者（33例男性和29例女性；平均年龄54岁[标准差±15岁；范围，22至83岁]）。在第1次检查时，右眼整体平均偏差的相对改善率为30.8%（P = 0.01），左眼为13.7%（P = 0.3067）。在第2次检查时，右眼整体平均偏差的相对改善率为30.4%（P = 0.0142），左眼为32.6%（P = 0.0092）。在第1次和第2次检查时，颞下象限是改善最明显的象限（第1次检查，右眼，37.8%[P = = 0.0082]；第2次检查，左眼，30.8%[P = 0.0074]）。在第3次、第4次和第5次检查时，观察到整体有轻度改善的趋势，仅在左眼颞下象限从第2次检查到第3次检查时有统计学意义，改善了19.7%（P = 0.0270）。
前视觉通路减压后视觉功能的恢复模式表明至少有三个改善阶段。早期快速改善阶段（手术至1周）可能使一些患者的视野恢复正常。早期缓慢改善阶段（1个月至4个月）是改善最显著的时期。后期轻度改善阶段（6个月至3年）总体上似乎不显著，但在一些患者中可能较为明显。这些阶段中的每一个阶段可能都有一个或多个导致观察到的改善的机制。
