Analysis of risk factors for visual acuity and visual field impairments in patients with pituitary adenoma

Abstract

Objective To investigate the risk factors for visual acuity and visual field impairments, and the effect on their prognoses. Methods The clinical data of 637 patients with pituitary adenoma operated at the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from January 2008 to December 2013 were analyzed retrospectively. The patients were followed up at 3 years after procedure. Receiver operating characteristic (ROC) curve was used to obtain the optimal critical value of the risk factors for affecting visual acuity and visual field impairments and postoperative recovery. The round numbers were taken to group. Results In 637 patients, 436 (68.4%) experienced visual acuity and visual field impairments, 414 of them had decreased vision, and 292 had visual field defect. Receiver operating characteristic (ROC) curve showed that (1) the suprasellar extension height of tumors 10 mm group (all P 18.5 mm, the risk of causing permanent visual acuity and visual field impairments increased. There were significant differences in postoperative visual acuity improvement, visual acuity and visual field impairment score (VIS) grades between the suprasellar extension height of tumors ≤20 mm group and the and >20 mm group (P 0.05); (3) the patients with the duration of preoperative visual acuity and visual field impairments >13.5 months, the postoperative visual acuity and visual field impairments were more difficult to improve. There was significant difference between the recovery of visual acuity in patients with the duration of the disease >12 months after operation and the VIS grade poor than ≤12 months. Conclusions The greater the height of pituitary adenoma extending to the suprasaddle, the higher the probability of visual acuity and visual field impairments. The improvement of visual acuity and visual field after procedure is associated with the height of tumors extending to the suprasaddle and the course of visual acuity and visual field impairments. Key words: Pituitary neoplasms; Vision disorders; Risk factors