Stages of improvement in visual fields after pituitary tumor resection
Stages of improvement in visual fields after pituitary tumor resection
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DOI：
10.1016/s0002-9394(00)00539-0
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发表时间：
2000-12-01
影响因子：
4.2
通讯作者：
Newman, NJ
中科院分区：
文献类型：
--
作者：
Kerrison, JB;Lynn, MJ;Newman, NJ
目得：使用静态阈值视野检查的阶段，改善和潜在的后期改善的视野手术切除垂体腺瘤后，造成视觉损失的压缩的前视觉pathways.METHODS：回顾性审查的图表垂体瘤和异常静态阈值视野检查的患者治疗前或治疗后不久谁有随后的视野。对总体、颞上和颞下视野平均偏差进行量化，并在两次访视之间进行比较。术后访视分为5个时间段：访视1（手术至1周），访视2（1个月至4个月），访视3（6个月至1年）、访视4（2年）和访视5结果：62例患者纳入研究（33名男性和29名女性;平均年龄54岁[SD +/- 15岁;范围，22 - 83岁]），访视1时，右眼的总体平均偏差的相对改善为30.8%（P = 0.01），左眼为13.7%（P = 3067）。访视2时，右眼总体平均偏差的相对改善为30.4%（P = 0.0142），左眼为32.6%（P = .0092），在访视1和2时，颞下象限是改善最大的象限（访视1，右眼，37.8% [P = .0082];第2次访视，左眼，30.8% [P = 0.0074]）。在第3、4和5次访视时，从第2次访视到第3次访视，仅左眼的颞下象限观察到总体趋势轻度改善，具有统计学显著性，结论：前视路减压术后视功能恢复的模式提示至少有3个阶段的改善，早期快速期（手术至1周）的改善可能导致部分个体视野正常化。早期缓慢期（1个月至4个月）是最显著改善的时期。晚期（6个月至3年）的轻度改善总体上并不显着，但在某些个体中可能很明显。这些阶段中的每一个都可能有一个或多个机制来支持所观察到的改善。(C)2000年，Elsevier Science Inc. All rights reserved.
PURPOSE: To use static threshold perimetry to examine the stages of improvement and the potential for late improvement of visual fields after surgical resection of pituitary adenomas causing visual loss from compression of the anterior visual pathways.METHODS: Retrospective review of charts of patients with pituitary tumors and abnormal static threshold perimetry before or soon after treatment who had subsequent visual fields. Quantification of the visual field mean deviation overall, superotemporally, and inferotemporally was performed and compared between visits. Postoperative visits were considered in five time periods: visit 1 (surgery to 1 week), visit 2 (1 month to 4 months), visit 3 (6 months to 1 year), visit 4 (2 years), and visit 5 (3 or more years).RESULTS: Sixty-two patients were included (33 men and 29 women; mean age 54 years [SD +/- 15 years; range, 22 to 83 years]), At visit 1, the relative improvement of the overall mean deviation for the right eye was 30.8% (P = .01) and for the left eye was 13.7% (P = 3067). At visit 2, the relative improvement of the overall mean deviation for the right eye was 30.4% (P = .0142) and for the left eye was 32.6% (P = .0092), At visits 1 and 2, the inferotemporal quadrants were the quadrants with greatest improvement (visit 1, right eye, 37.8% [P = .0082]; visit 2, left eye, 30.8% [P = .0074]), At visits 3, 4, and 5, an overall trend toward mild improvement was observed with statistical significance only for the inferotemporal quadrant of the left eye from visit 2 to visit 3, which improved 19.7% (P = .0270).CONCLUSION: The pattern of recovery of visual function after decompression of the anterior visual pathways suggests at least three phases of improvement, The early fast phase (surgery to 1 week) of improvement may lead to normalization of visual fields in some individuals. The early slow phase (1 month to 4 months) is the period of most notable improvement. A late phase (6 months to 3 years) of mild improvement does not appear significant overall but may be marked in some individuals. Each of these phases may have one or more mechanisms underlying the observed improvement. (C) 2000 by Elsevier Science Inc. All rights reserved.