Visual Field Recovery And Prognostic Factors Of Visual Field Improvement After Trans-sphenoidal Approach For Pituitary Adenomas

Objective:Perimetry is important in the diagnosis of Visual pathway disease, pituitary adenoma may compress the optic chiasm producing loss of vision. The study is to report the quantitative assessment of visual fields (VF) in patients with pituitary macroadenomas, and the time course and predictive factors for recovery of vision; Medthod:Retrospective study of78patients with pituitary adenomas and visual disturbance from March2012to March2013,Patients underwent pre-and postoperative VF assessment at one week, three to six months, using the Humphrey field analyser, Pituitary MRI, endocrine examination. Results:Impairment of VF was greatest in the upper temporal quadrant, followed by the lower temporal. VF recovery was progressive and apparent even at3-6months follow up;Overall, VF returned to normal in31.7%of eyes,improved in59.1%, and remained unchanged in9.2%. Patients whose VF returned to normal had a shorter duration of symptoms (P<0.05), better preoperative visual acuity (P<0.05), and a smaller degree of impairment in preoperative lateral quadrant VF (P＜0.01) than those whose VF only improved.Multivariate logistic regression showed that factors, independently predictive for complete recovery, were as follows:low Preoperative MD absolute value (p=0.008), low craniocaudal diameter of tumour (P=0.04) and young age (p=0.001). Conclution:We achieved a complete recovery and an improvement of the visual field after surgery in89.7%of the patiernts after followed3-6mounth; Factors, independently predictive for complete recovery, were as follows:low Preoperative MD absolute value,low craniocaudal diameter of tumour and young age.