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使用鞍区肿瘤大小作为心理物理学和电生理视野缺损的预测指标:一种逻辑回归方法。

Using sellar region tumor's size as a predictor of psychophysical and electrophysiological perimetric visual losses: a logistic regression approach.

作者信息

Lobão Carlos Augusto Ferreira, Miquilini Letícia, da Silva Breno Simões Ribeiro, da Silva Verônica Gabriela Ribeiro, Lacerda Eliza Maria da Costa Brito, Rosa Alexandre Antônio Marques, Souza Givago da Silva

机构信息

Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.

Núcleo de Teoria e Pesquisa do Comportamento, Universidade Federal do Pará, Belém, Brazil.

出版信息

Doc Ophthalmol. 2019 Dec;139(3):235-245. doi: 10.1007/s10633-019-09709-3. Epub 2019 Jul 23.

Abstract

BACKGROUND

Sellar region tumor growth represents an important cause of visual loss due to mechanical compression of the optic nerve apparatus. Many investigations have used non-invasive tools to evaluate the visual field consequences of this damage, and good associations have been reported between psychophysical and electrophysiological perimetries. Few reports have considered the tumor size as a predictor of visual field loss.

AIMS

In the present study, we evaluated the association between the visual perimetry measured by Humphrey visual field analyzer and multifocal visual evoked cortical potential (mfVECP) and the tumor size.

METHODS

Our sample was composed of 14 patients diagnosed with sellar tumors by magnetic resonance imaging. We accounted the number of sectors with negative visual responses for both methods. A simple logistic regression analysis was used to evaluate the association between the tumor dimensions and the visual field features RESULTS: Three patients had preserved visual fields, three patients showed hemianopic defects, and eight patients had generalized visual field losses at both evaluations. We observed that the three maximum diameters of the tumor and total tumor volume had different predictive abilities regarding the extent of visual field loss when using psychophysical and mfVECP data. The maximum craniocaudal diameter of the tumor was the better predictor of the psychophysical measurements, whereas for the mfVECP results, all tumor dimensions and volumes had similar values that predict visual field losses.

CONCLUSION

Tumor size as a predictor of visual loss has potential to assist in the clinical intervention and to prevent the irreversible visual impairment caused by tumors of the sellar region.

摘要

背景

鞍区肿瘤生长是导致视神经装置机械性压迫从而造成视力丧失的重要原因。许多研究已使用非侵入性工具来评估这种损伤对视野的影响,并且心理物理学和电生理视野检查之间已报告有良好的相关性。很少有报告将肿瘤大小视为视野丧失的预测指标。

目的

在本研究中,我们评估了通过 Humphrey 视野分析仪测量的视野检查和多焦视觉诱发电位(mfVECP)与肿瘤大小之间的相关性。

方法

我们的样本由通过磁共振成像诊断为鞍区肿瘤的 14 名患者组成。我们统计了两种方法中视觉反应为阴性的扇区数量。使用简单逻辑回归分析来评估肿瘤大小与视野特征之间的相关性。结果:在两次评估中,三名患者视野保留,三名患者出现偏盲缺陷,八名患者出现广泛性视野丧失。我们观察到,在使用心理物理学和 mfVECP 数据时,肿瘤的三个最大直径和肿瘤总体积对于视野丧失程度具有不同的预测能力。肿瘤的最大头尾直径是心理物理学测量结果更好的预测指标,而对于 mfVECP 结果,所有肿瘤尺寸和体积在预测视野丧失方面具有相似的值。

结论

肿瘤大小作为视力丧失的预测指标,有可能协助临床干预并预防鞍区肿瘤引起的不可逆视力损害。

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