Neuroophthalmological symptoms of pituitary adenomas with supraparasellar extension
Journal Title: Офтальмологический журнал - Year 2019, Vol 0, Issue 5
Abstract
Background: Pituitary adenomas (PA) are benign neoplasms that arise from adenohypophysis; they are most common skull base tumors, and account for 12% to15% of all intracranial tumors. In PA with supraparasellar extension, a tumor grows upward, causing chiasmal and lateral cavernous sinus compression. Because prolonged compression of the optic nerve/chiasm complex results in the development of primary descending ONA in 31% to 72% of patients, leading to blindness in 3.5% to 16% of patients, the issue is worthy of attention. Purpose: To investigate neuro-ophthalmological symptoms in pituitary adenomas with a supraparasellar extension before and after treatment. Materials and Methods: This retrospective study included the records of 107 patients who received treatment for pituitary adenomas with a supraparasellar extension at the Romodanov Institute during 2017 to 2018. The main group included 49 patients (98 eyes) who had visual impairments and/or visual field deficits. Patients underwent clinical and neurological, eye and otoneurological examination (including neuroimaging studies) before and after treatment. Results: Visual impairments with the development of markedly asymmetric chiasmal syndrome were most common in the clinical picture, with a severe visual acuity loss (25.5% of eyes) and significant sensitivity loss (39.8% of eyes) in the more affected eye, mild or moderate visual acuity loss and visual field loss in the less affected eye, and development of primary descending optic nerve atrophy in 36 (73.5%) patients. After treatment, visual acuity restored or improved in 57 (58.2%) eyes, and arithmetic mean of the sensitivity loss, the mean defect (MD), improved in 46 (46.9%) eyes (these improvements were significant, p < 0.05). Conclusion: Pituitary adenomas with supraparasellar extension were characterized by the development of visual and oculomotor impairments, which evidenced the presence of various directions of tumor expansion. Visual impairments with the development of markedly asymmetric chiasmal syndrome were most common in the clinical picture. Mean BCVA improved from 0.51±0.04 at baseline to 0.66±0.03 after treatment, and mean overall visual field sensitivity loss improved from 12.11 ± 0.69 dB at baseline to 8.6 ± 0.7 dB after treatment (both improvements were significant, p < 0.05).
Authors and Affiliations
K. Iegorova, M. Guk, O. Guk, L. Danevych, D. Tsiurupa
Keywords
Related Articles
- EP ID EP664968
- DOI 10.31288/oftalmolzh201952226
- Views 125
- Downloads 0
Results of vitreous surgery with 20% C3F8/air mixture for macular holes larger than 800 μm
Background: Vitreous surgery for large macular holes is still a challenge to the ophthalmologist. Purpose: To assess the efficacy of the 20% C3F8/air mixture in the vitrectomy surgery for macular holes > 800 μm in diame...
Primary open-angle glaucoma progression depending on clinical indices at presentation
Background: Given the importance of developing simple and efficient methods for the diagnosis and prognosis of primary open-angle glaucoma (POAG), we have previously proposed an index of progression of glaucoma stage (IP...
Intraoperative changes in intraocular temperature during vitrectomy procedures with irrigating solutions differing in temperature
Background: Intraoperative intraocular media and irrigation fluid temperature monitoring is not performed during vitreoretinal surgery in current clinical practice. Purpose: To investigate intraoperative changes in intr...
Effect of phosphocreatine on ocular hemodynamics and functional status of the macula in patients with dry age-related macular degeneration
Background. Age-related macular degeneration (AMD) comprises 12.5% and 22% in the structure of ocular incapacitation among persons of working and pension age, respectively. The important role in the pathogenesis of AMD b...
Our current understanding of metastasis and the potential for predicting the course of head and neck squamous cell carcinoma
This review presents recent studies on the mechanisms of malignant neoplasm metastases, particularly, in head and neck squamous cell carcinoma (HNSCC). The involvement of circulating tumor cells (CTC) and cancer stem cel...