Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20-Geumo-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 50612, South Korea.
Department of Ophthalmology, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
Int Ophthalmol. 2021 Jun;41(6):2019-2026. doi: 10.1007/s10792-021-01757-6. Epub 2021 Feb 24.
To analyze the factors influencing visual field recovery in patients with pituitary adenoma following surgical treatment.
We retrospectively reviewed 144 eyes of 72 patients with pituitary adenoma who had been followed up for more than 6 months following surgery between January 2016 and December 2019. Pre and postoperative visual acuity, visual field test and retinal nerve fiber layer (RNFL) thickness were investigated. We defined recovery of visual field defects as being an improvement in mean deviation (MD) of 2 dB or more.
The average age of the 72 patients (144 eyes) was 51.94 ± 14.69 years, making for 37 patients in the recovery group and 35 patients in the non-recovery group. Preoperative MD, pattern standard deviation (PSD), and visual field indexes (VFI) were negatively correlated to postoperative MD, PSD and VFI changes and positively correlated to postoperative MD, PSD, and VFI values. Using multiple regression analysis, a shorter duration of symptoms (Odds ratio [OR], 0.990; p = 0.033), higher preoperative MD values (OR, 0.871; p = 0.025), and thicker temporal RNFL (OR, 1.068; p = 0.048) were associated with a visual field recovery following surgery.
The prognosis for visual field recovery is favorable for patients who have a short period from symptom onset to surgery, a higher MD value of preoperative VF, and a thicker peripapillary temporal RNFL thickness. Therefore, the preoperative MD, temporal RNFL thickness, and the symptom period can be predictive variables affecting postoperative visual field recovery.
分析影响垂体腺瘤患者术后视野恢复的因素。
回顾性分析 2016 年 1 月至 2019 年 12 月期间随访时间超过 6 个月的 72 例垂体腺瘤患者的 144 只眼。调查术前和术后视力、视野检查和视网膜神经纤维层（RNFL）厚度。我们将视野缺损的恢复定义为平均偏差（MD）改善 2dB 或更多。
72 例（144 只眼）患者的平均年龄为 51.94±14.69 岁，其中恢复组 37 例，未恢复组 35 例。术前 MD、模式标准差（PSD）和视野指数（VFI）与术后 MD、PSD 和 VFI 变化呈负相关，与术后 MD、PSD 和 VFI 值呈正相关。多因素回归分析显示，症状持续时间较短（比值比[OR]，0.990；p=0.033）、术前 MD 值较高（OR，0.871；p=0.025）和颞侧 RNFL 较厚（OR，1.068；p=0.048）与术后视野恢复相关。
对于从发病到手术时间短、术前视野 MD 值较高、视盘周围颞侧 RNFL 较厚的患者，其视野恢复的预后良好。因此，术前 MD、颞侧 RNFL 厚度和症状持续时间可作为影响术后视野恢复的预测变量。
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