Visual Outcome after Transsphenoidal Surgery in Patients with Pituitary Apoplexy

Title
Visual Outcome after Transsphenoidal Surgery in Patients with Pituitary Apoplexy
Author
정진환
Keywords
Outcome; Pituitary apoplexy; Transsphenoidal surgery; Vision
Issue Date
2011-06
Publisher
대한신경외과학회
Citation
Journal of Korean neurosurgical society / 대한신경외과학회지. 2011 49(6):339-344
Abstract
Objective : Pituitary apoplexy is one of the most serious life-threatening complications of pituitary adenoma. The purpose of this study is to investigate the visual outcome after early transsphenoidal surgery for the patients with pituitary apoplexy. Methods : We retrospectively reviewed the 31 patients with pituitary apoplexy who were admitted due to acute visual acuity or field impairment and treated by transsphenoidal surgery. Five patients were excluded because of the decreased conscious level. The visual acuity of each individual eye was evaluated by Snellen's chart Visual fields were also checked using automated perimetry. To compare the visual outcome according to the surgical timing, we divided the patients into 2 groups. The first group, 21 of the patients have been undertaken transsphenoidal approach (TSA) within at least 48 hours after admission. The second group included 8 patients who have been undertaken TSA beyond 48 hours. All patients were monitored at least 12 months after surgery. Results : Patients were 21 males and 8 females (M : F=2.6 : 1) with the mean age of 42.4 years. Among the enrolled 29 patients, 26 patients presented with decreased visual acuity and 23 patients revealed the defective visual field respectively. Postoperatively, improvement in the visual acuity was seen in 15 patients (83.3%) who underwent surgery within the first 48 hours of presentation, as compared to those in whom surgery was delayed beyond 48 hours (n=5; 62.5%) (p=0.014). Improvement in the visual field deficits was observed in 15 (88.2%) of patients who had been operated on within the first 48 hours of presentation, as compared to those in whom surgery was delayed beyond 48 hours (n=3; 50.0%) (p=0.037). Conclusion : This study suggests that rapid transsphenoidal surgery is effective to recover the visual impairment in patients with pituitary apoplexy. If there are associated abnormalities of visual acuity or visual fields in patients with hemorrhagic pituitary apoplexy, early neurosurgical intervention within 48 hours should be also required to recover visual impairment.
URI
http://www.ndsl.kr/ndsl/search/detail/article/articleSearchResultDetail.do?cn=JAKO201123457284643&SITE=CLICKhttps://www.jkns.or.kr/journal/view.php?doi=10.3340/jkns.2011.49.6.339
ISSN
1598-7876; 2005-3711
DOI
10.3340/jkns.2011.49.6.339
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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