Conservative management of pituitary macroadenoma contacting the optic apparatus.

OBJECTIVES

To describe the tumor characteristics and visual function in conservatively managed patients with non-functioning pituitary macroadenoma (NFMA) that contacted/compressed the visual pathway.

DESIGN

Retrospective case-series.

SETTING

Tertiary-care academic institution.

PARTICIPANTS

Six patients with diagnosis of NFMA.

MAIN OUTCOME

Visual function and radiological characteristics of the optic apparatus and pituitary tumor.

RESULTS

All patients had radiological evidence of optic apparatus compression but only one had visual field defect at the initial presentation. While two of the six patients developed visual field changes during followup (41±34.8 months), the patient with visual field defect at the time of diagnosis improved to normal vision.

CONCLUSIONS

Select NFMAs that contact the optic apparatus, without visual dysfunction, may be managed with close ophthalmological and radiographic monitoring, depending on tumor and imaging characteristics. This may be of particular relevance in patients considered to have a high peri-operative risk, such as advanced age or significant co-morbidities.