Effectiveness of computer-assisted perimetry in the follow-up of patients with pituitary microadenoma responsive to medical treatment.
METHODS
Patients were studied before and after 1 year of bromocriptine or 6 months of SMS 201-995 treatment, for prolactinomas or GH-secreting adenomas, respectively.


METHODS
Seventeen patients with intrasellar pituitary tumour (ten prolactinomas, all females; seven GH-secreting adenomas, four males and three females) and the presence of relative or absolute scotomas, were examined.


METHODS
We used computed tomodensitometry, Goldman perimeter and computer-assisted perimetry.


RESULTS
The patients were divided into three groups according to their response to medical treatment as proved by computed tomodensitometry which revealed the disappearance of the tumour in four prolactinomas (group 1), a reduction > 40% in three prolactinomas and in three acromegalics (group 2) and no significant variation in the diameter of the adenoma in three prolactinomas and in four acromegalics (group 3). Comparison by the paired t-test of the visual fields before and after treatment revealed a significant positive change (P < 0.01) for all patients in groups 1 and 2 and for one patient in group 3, with disappearance of the scotomas in all cases in group 1 and in two cases in group 2. Visual field defects were detected by means of the Goldman perimeter in only one patient with prolactinoma and in two acromegalics, although the computer-assisted perimetry showed that, in 15 out of 17 patients, visual impairment was unilateral and in all cases the presence of relative scotomas was concentrated in the upper temporal quadrant. The visual defects observed with computer-assisted perimetry and the pituitary tumour dimension evaluated with computed tomodensitometry did not show significative correlations (r = 0.059, P NS).


CONCLUSIONS
Computer-assisted perimetry was most useful in the diagnosis and follow-up of patients with pituitary adenoma, especially in the evaluation of small masses without subjective symptoms of visual loss, when the Goldman perimeter does not usually allow us to recognize minimal chiasmatic involvements or the improvement of visual field as a result of the medical therapy.
Cannavó
S
S
Cattedra di Endocrinologia, University of Messina, Italy.
De Natale
R
R
Curtó
L
L
Li Calzi
L
L
Trimarchi
F
F
D000172:Acromegaly / Q000175:diagnosis; D000236:Adenoma / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D015282:Octreotide / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000175:diagnosis*; D015175:Prolactinoma / Q000175:diagnosis*; D012607:Scotoma / Q000175:diagnosis; D058609:Visual Field Tests / Q000379:methods*
D001971:Bromocriptine; D015282:Octreotide