title: Predictive model for recovery of visual field after surgery of pituitary adenoma.
abstract: Visual field defect is a major indication for surgery of pituitary adenoma, but visual outcome after surgery is difficult to predict. We developed a nomogram that predicts postoperative restoration of visual field defects in patients with pituitary adenoma. This study was a retrospective cohort investigation of patients who were treated for pituitary adenoma between January 2009 and December 2013. We enrolled 111 eyes of 57 patients who completed one ophthalmological evaluation preoperatively and at least two evaluations within 6 months after surgery. Serial changes in visual fields and retinal nerve fiber layer (RNFL) thickness were evaluated. Multiple logistic regression analysis was performed to select prognostic variables, and a nomogram to predict restoration of visual field defects was constructed. Visual field defects continuously improved until 3 months after surgery. However, average, superior, and inferior RNFL thickness continuously decreased until 6 months after surgery. Multiple logistic regression analysis revealed that worse preoperative visual field defect (p = 0.018), high MRI compression grade (p = 0.009), and inferior RNFL thinning (p = 0.011) were significantly associated with worse visual outcome. The nomogram that predicts the visual restoration showed an area under the receiver operating characteristic curve of 0.84. In conclusion, we developed a nomogram that predicted the restoration of visual field defects after removal of pituitary adenoma. This would allow tailored counseling of individual patients by precisely predicting visual recovery after surgery.
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, 120-752, South Korea.
authors.forename: Junwon
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Policy Research Affairs, National Health Insurance Corporation Ilsan Hospital, Goyang, South Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
authors.forename: Joo Youn
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, 120-752, South Korea.
authors.forename: Moonjung
authors.initials: M
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea.|Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea.|Pituitary Tumor Clinic, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Oh
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Seung Min
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea.|Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea.|Pituitary Tumor Clinic, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Eui Hyun
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea.|Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea.|Pituitary Tumor Clinic, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sun Ho
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, 120-752, South Korea. shbyeon@yuhs.ac.
authors.forename: Suk Ho
authors.initials: SH
authors.lastname: Byeon
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D015331:Cohort Studies; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000379:methods*; D049451:Nomograms; D010911:Pituitary Neoplasms / Q000601:surgery*; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000502:physiology*; D012160:Retina / Q000473:pathology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*
keywords: Nomogram; Pituitary adenoma; Visual field