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经蝶窦手术治疗垂体腺瘤后的与视觉相关的生活质量。

Vision-related quality of life after transsphenoidal surgery for pituitary adenoma.

机构信息

Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.

出版信息

Invest Ophthalmol Vis Sci. 2010 Jul;51(7):3405-10. doi: 10.1167/iovs.09-3763. Epub 2010 Feb 24.

DOI:10.1167/iovs.09-3763
PMID:20181847
Abstract

PURPOSE. To use the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) to evaluate vision-related quality of life (VR-QOL) in patients with pituitary adenoma who undergo transsphenoidal surgery. METHODS. The VFQ-25 was self-administered by 74 patients with pituitary adenoma before and 3 months after surgery. Pre- and postoperative clinical data were collected, including age, sex, tumor type and size, logarithm of minimum angle of resolution best corrected visual acuity (logMAR BCVA), critical flicker fusion frequency, static perimetry scores (mean deviation [MD] and corrected pattern SD [CPSD]), duration of ocular symptoms, and number of systemic comorbidities. RESULTS. Seventy-four patients with a mean age of 48.2 years were studied. Transsphenoidal surgery for pituitary adenoma significantly improved logMAR BCVA and critical fusion flicker frequency in the worse-seeing eye and MD and CPSD scores in both the better- and worse-seeing eyes (P < 0.001). The VFQ-25 composite score and all subscale scores, except those for the general health and color vision subscales, improved significantly (P < 0.05). A multivariate regression analysis revealed that the preoperative VFQ-25 composite score and the preoperative MD and CPSD scores in the better-seeing eye were related to the postoperative VFQ-25 composite score (P < 0.05). CONCLUSIONS. This study quantitatively demonstrated that transsphenoidal surgery can dramatically improve VR-QOL in pituitary adenoma and that the preoperative VFQ-25 composite score and visual field disturbance in the better-seeing eye are particularly important predictors associated with the postoperative VR-QOL. The use of VFQ-25 provides a more comprehensive overview of the effectiveness of transsphenoidal surgery.

摘要

目的。使用 25 项国家眼科研究所视觉功能问卷(VFQ-25)评估经蝶窦手术的垂体腺瘤患者的视觉相关生活质量(VR-QOL)。

方法。74 例垂体腺瘤患者在术前和术后 3 个月自行使用 VFQ-25 进行评估。收集术前和术后的临床资料,包括年龄、性别、肿瘤类型和大小、最小分辨角对数最佳矫正视力(logMAR BCVA)、临界闪烁融合频率、静态视野评分(平均偏差[MD]和矫正模式标准偏差[CPSD])、眼部症状持续时间和全身性合并症数量。

结果。研究纳入了 74 例平均年龄为 48.2 岁的患者。经蝶窦手术治疗垂体腺瘤可显著改善较差眼的 logMAR BCVA 和临界闪烁融合频率,以及较好眼的 MD 和 CPSD 评分(P < 0.001)。VFQ-25 综合评分和所有子量表评分(除一般健康和色觉子量表外)均显著改善(P < 0.05)。多变量回归分析显示,术前 VFQ-25 综合评分和较好眼的术前 MD 和 CPSD 评分与术后 VFQ-25 综合评分相关(P < 0.05)。

结论。本研究定量证明了经蝶窦手术可以显著改善垂体腺瘤患者的 VR-QOL,且较好眼的术前 VFQ-25 综合评分和视野障碍是与术后 VR-QOL 相关的重要预测因素。VFQ-25 的使用提供了经蝶窦手术有效性的更全面概述。

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