Visual recovery after treatment for pituitary adenoma.
Visual functions were studied pre- and post-operatively in 128 patients treated for pituitary adenoma with operations by intracranial (89 patients) or transsphenoidal approach (39 patients). Most patients were given post-operative irradiation. Follow-up was 6 months or more. Visual field defects were seen pre-operatively in 85% of the patients operated intracranially and in 36% of the patients operated transsphenoidally. Visual acuity was reduced, at least in one eye, in 64% of the patients in the former group and in 26% of the latter group. Additional diagnostic information was obtained from recordings of visually evoked cortical potentials. After intracranial operations visual acuity was normalized or improved in 65% and visual fields in 82% of the patients with pre-operative visual defects. After transsphenoidal operations the corresponding values were 56% and 92%. A detailed analysis of the visual acuity showed that eyes with optic atrophy pre-operatively improved to a very limited extent. Other pre-operative ophthalmological disturbances were of much less prognostic significance. Improvement of vision was often gradual and could continue for more than a year after treatment. Even if visual acuity and visual fields had been completely restored, visually evoked cortical potentials could remain impaired, indicating that evoked potentials might be a very sensitive test for the evaluation of visual recovery.
D000239:Adenoma, Acidophil / Q000601:surgery*; D000238:Adenoma, Chromophobe / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery*; D014792:Visual Acuity; D014793:Visual Cortex / Q000502:physiology; D014794:Visual Fields; D014796:Visual Perception / Q000502:physiology*