Wang Hanbin, Sun Wei, Fu Zhuang, Si Zhichao, Zhu Yufang, Zhai Guode, Zhao Guangyu, Xu Shangchen, Pang Qi
Department of Neurosurgery, Shandong Provincial Hospital, Shandong University, Jinan, China.
J Int Med Res. 2008 Sep-Oct;36(5):1064-9. doi: 10.1177/147323000803600525.
This retrospective study aimed to identify the pattern of visual impairment in pituitary adenoma patients. Patients' eyes were categorized into four groups according to their visual acuity score. Trans-sphenoidal hypophysectomy was performed on all patients. Significant differences between groups were evaluated for visual field defects, visual symptoms duration, degree of suprasellar extension and tumour pathology. In the 201 patients (402 eyes) evaluated, 166 eyes had impaired visual acuity (45 eyes, < 4.0; 43 eyes, 4.0 - 4.4; and 78 eyes, 4.5 - 4.8), 236 eyes scored > 4.8 and were considered to be free of this disorder. A linear correlation was found between visual field defects and visual acuity score. Duration of visual symptoms between visual acuity groups was not significant. Suprasellar extension (measured by Hardy grades) was significant between visual acuity groups and may be the main cause of visual acuity loss in pituitary adenoma patients. Non-functional pituitary adenomas tended to affect visual acuity more than adenomas with other pathological diagnoses which are adrenocorticotropic hormone and prolactin. Further investigation is required to clarify visual loss cause in pituitary adenoma patients.
这项回顾性研究旨在确定垂体腺瘤患者的视力损害模式。根据患者的视力评分将其眼睛分为四组。所有患者均接受经蝶窦垂体切除术。对各组之间在视野缺损、视觉症状持续时间、鞍上扩展程度和肿瘤病理方面的显著差异进行了评估。在评估的201例患者（402只眼）中，166只眼视力受损（45只眼，<4.0；43只眼，4.0 - 4.4；78只眼，4.5 - 4.8），236只眼评分>4.8，被认为无此病症。发现视野缺损与视力评分之间存在线性相关性。视力组之间的视觉症状持续时间无显著差异。鞍上扩展（通过哈代分级测量）在视力组之间具有显著性，可能是垂体腺瘤患者视力丧失的主要原因。无功能性垂体腺瘤比其他病理诊断为促肾上腺皮质激素和催乳素的腺瘤更容易影响视力。需要进一步研究以阐明垂体腺瘤患者视力丧失的原因。
