title: Discrepancy between structural and functional visual recovery in patients after trans-sphenoidal pituitary adenoma resection.
abstract: OBJECTIVE
  The relationship between functional and structural measurements is of fundamental importance in monitoring treatment and progression in patients with pituitary adenoma. In the present study, we examined the association between longitudinal changes in standard automated perimetry (SAP), retinal nerve fiber layer (RNFL) thickness and multifocal visual evoked potential (mfVEP) amplitude after transsphenoidal surgery.
  
  
  METHODS
  Thirty patients with pituitary adenoma were recruited from Huashan Hospital between September 2010 and January 2014. The examination included pupil examination, anterior and posterior segment examination, SAP, RNFL and mfVEP. At three months and nine months after transsphenoid surgery, follow-up measurements were conducted in twenty-three patients, and at 18 months after surgery, the same examinations were performed in seven patients.
  
  
  RESULTS
  The average age of patients was 42.6±12.1years, with 23 males and 7 females. The mean score of SAP improved significantly: 1.75 before surgery; 0.62 at three months after surgery (p=0.00) and 0.50 at nine months after surgery (p=0.00). No significant improvement in RNFL thickness was observed at three months or nine months after surgery. The mean score of mfVEP also improved significantly: 0.85 before surgery; 0.53 at three months (p=0.00) and 0.38 at nine months after surgery (P=0.00). No statistical difference was observed in the outcome of patients at nine months of follow-up and 18 months of follow-up.
  
  
  CONCLUSIONS
  Visual field and mfVEP recovery with unchanged RNFL thickness was observed in patients after transsphenoid pituitary adenoma resection.
authors.affiliation: Shanghai Pituitary Tumor Center, Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wulumuqi Zhong Road, Shanghai, 200040, China.
authors.forename: Nidan
authors.initials: N
authors.lastname: Qiao
authors.affiliation: Shanghai Pituitary Tumor Center, Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wulumuqi Zhong Road, Shanghai, 200040, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Ye
authors.affiliation: Shanghai Pituitary Tumor Center, Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wulumuqi Zhong Road, Shanghai, 200040, China.
authors.forename: Xuefei
authors.initials: X
authors.lastname: Shou
authors.affiliation: Shanghai Pituitary Tumor Center, Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wulumuqi Zhong Road, Shanghai, 200040, China.
authors.forename: Yongfei
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Shanghai Pituitary Tumor Center, Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wulumuqi Zhong Road, Shanghai, 200040, China.
authors.forename: Shiqi
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Shanghai Pituitary Tumor Center, Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wulumuqi Zhong Road, Shanghai, 200040, China. Electronic address: zhaoyaohs@hotmail.com.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010911:Pituitary Neoplasms / Q000601:surgery*; D020127:Recovery of Function / Q000502:physiology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D013101:Sphenoid Sinus / Q000601:surgery; D041623:Tomography, Optical Coherence; D014794:Visual Fields / Q000502:physiology*
keywords: Mutifocal visual evoked potential; Recovery; Retinal nerve fiber layer; Visual field