Clinical characteristics and ophthalmologic findings of pituitary adenoma in Korean patients

Abstract

To investigate the clinical characteristics of and ophthalmic findings in Korean patients diagnosed with a pituitary adenoma. The medical records of 534 patients diagnosed with a pituitary adenoma at Kyung Hee University Hospital between January 2007 and December 2016 were retrospectively reviewed. Mean patient age was 47.9±16.2years. The most common symptoms at the time of presentation were headache (26.2%) and visual disturbance (12.4%). The referral rate to the ophthalmology department was 18.44% and patients most often presented to the neurosurgery department. Optic chiasm compression was identified in 23.4% of patients (54.4% of patients referred to ophthalmology, 15.0% of patients not referred to ophthalmology). Normal visual field (57%) was the most common visual field feature followed by bitemporal hemianopsia (17.8%). Optic chiasmal compression without visual field defects was found in 36.1% of patients. Tumor volume was positively correlated with visual field pattern standard deviation (PSD, p=0.020) and best-corrected logMAR visual acuity (p=0.000) and negatively associated with tumor volume and visual field mean deviation (MD, p=0.000). Best-corrected visual acuity (p=0.000), MD (p=0.001), and PSD (p=0.028) significantly improved after surgery. Pituitary adenoma patients do not always have ocular symptoms at their first presentation, even when optic chiasm compression and visual field deficits are present. Therefore, collaboration with an ophthalmologist is important when evaluating pituitary adenoma patients.