Visual outcomes after endoscopic pituitary adenomas surgery: our experience

Abstract

AbstractPurposeTo evaluate visual outcomes after endoscopic pituitary adenoma surgery in patients from Egas Moniz hospital between 2013 and August 2020.MethodsThis is a quantitative, observational, retrospective study. Patients with pituitary adenoma with pre‐ and post‐ surgical visual acuity (LogMAR) and chromatic vision assessment, visual field (Octopus®) testing and optical coherence tomography (Heidelberg®) retinal nerve fibers and macular thickness evaluations were included. Visual parameters were subjected to statistical analysis using SPSS T‐test and Wilcoxon test. A statistically significant p‐value was defined as <0.05.ResultsEighteen patients fulfilled our inclusion criteria. Of the 18 patients, 10 (55.6%) were man, with an average age of 57.4 (±16.5) years old. Fourteen (77.8%) patients had pre‐surgical visual complains for an average of 12.8 (±14.4) months, mostly painless and progressive vision loss 6 (33.3%) and blurred vision 6 (33.3%). Before surgery, most patients (38.9%) already showed contact and opto‐chiasmatic lesion, with an average lesion diameter of 33.1 (±9.2) mm.The most common histological diagnosis was gonadotrophic adenoma (44.4%) with a low mean aggressiveness (Ki 67) of 2.3 (±1.1). Showed statistical significance the difference between the paired samples (pre‐ vs post‐) “opto‐chiasmatic relationship”, “right eye visual acuity”, “right eye visual field mean sensitivity”, “right eye temporal visual field mean sensitivity”, “left eye visual field mean sensitivity”, “left eye temporal mean sensitivity” and “left eye nasal visual field mean sensitivity”. Concerning improvement in tested variables, 11 (68.8%) patients improved in all variables and 14 (82.4%) improved in at least one.ConclusionsOur results go with the current scientific evidence that pituitary adenoma resection in patients with preoperative visual symptoms considerably improve these symptoms.