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The volume of tumor mass and visual field defect in patients with pituitary macroadenoma.

Lee JP, Park IW, Chung YS - Korean J Ophthalmol (2011)

Bottom Line: Twenty nine patients (74%) showed abnormal VF and bitemporal field changes, which were the most common field defects on presentation.Seven patients (18%) had unilateral VF defects, 22 patients (56%) had bilateral VF defects.SITA standard strategy can be a fast and quantitative method for evaluating central VF defects.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

ABSTRACT

Purpose: We used the Swedish interactive threshold algorithms (SITA) standard strategy of Humphrey perimetry, to analyze the pattern of visual field (VF) defects and evaluate the quantitative correlation between the tumor volume and severity of VF defects in patients with pituitary macroadenoma.

Methods: We reviewed 50 patients with pituitary macroadenoma who received VF test and 11 patients were excluded. VF analysis was performed with Humphrey perimeter using the SITA standard strategy. The tumor volume was assessed radiologically via brain magnetic resonance images and was calculated using Cavalieri's principle. We used the mean deviation (MD) and pattern standard deviation (PSD) of the Humphrey parameter to measure VF defect severity, and then analyzed the correlation of tumor volume with VF defects.

Results: Twenty nine patients (74%) showed abnormal VF and bitemporal field changes, which were the most common field defects on presentation. Seven patients (18%) had unilateral VF defects, 22 patients (56%) had bilateral VF defects. The tumor volume of the patients with VF defects was significantly larger than that of patients with normal VF (p = 0.006). The tumor volume exhibited significant negative correlation with MD (r = -0.693; p < 0.001) and significant positive correlation with PSD (r = 0.589; p < 0.001).

Conclusions: In patients with pituitary macroadenoma, there was a variety of VF defects and a high correlation between the tumor volume and the severity of VF defects. SITA standard strategy can be a fast and quantitative method for evaluating central VF defects.

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Humphrey visual field shows right incongruous homonymous hemianopia. Gadolinium-enhanced, T1-weighted magnetic resonance images of the brain reveal a mass that involves the optic tract.
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Figure 1: Humphrey visual field shows right incongruous homonymous hemianopia. Gadolinium-enhanced, T1-weighted magnetic resonance images of the brain reveal a mass that involves the optic tract.

Mentions: Types of VF defects in the patients are summarized in Table 2. Ten patients (26%) had normal VF and 29 patients (74%) had abnormal VF. Among the abnormal VF, seven patients (18%) had unilateral VF defects, and 22 patients (56%) had bilateral VF defects. Most of bilateral VF defects were bitemporal hemianopsia. Interestingly there were three patients with homonymous hemianopsia. These patients had a giant mass that involved the optic tract, one of which is shown in Fig. 1.


The volume of tumor mass and visual field defect in patients with pituitary macroadenoma.

Lee JP, Park IW, Chung YS - Korean J Ophthalmol (2011)

Humphrey visual field shows right incongruous homonymous hemianopia. Gadolinium-enhanced, T1-weighted magnetic resonance images of the brain reveal a mass that involves the optic tract.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3039193&req=5

Figure 1: Humphrey visual field shows right incongruous homonymous hemianopia. Gadolinium-enhanced, T1-weighted magnetic resonance images of the brain reveal a mass that involves the optic tract.
Mentions: Types of VF defects in the patients are summarized in Table 2. Ten patients (26%) had normal VF and 29 patients (74%) had abnormal VF. Among the abnormal VF, seven patients (18%) had unilateral VF defects, and 22 patients (56%) had bilateral VF defects. Most of bilateral VF defects were bitemporal hemianopsia. Interestingly there were three patients with homonymous hemianopsia. These patients had a giant mass that involved the optic tract, one of which is shown in Fig. 1.

Bottom Line: Twenty nine patients (74%) showed abnormal VF and bitemporal field changes, which were the most common field defects on presentation.Seven patients (18%) had unilateral VF defects, 22 patients (56%) had bilateral VF defects.SITA standard strategy can be a fast and quantitative method for evaluating central VF defects.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

ABSTRACT

Purpose: We used the Swedish interactive threshold algorithms (SITA) standard strategy of Humphrey perimetry, to analyze the pattern of visual field (VF) defects and evaluate the quantitative correlation between the tumor volume and severity of VF defects in patients with pituitary macroadenoma.

Methods: We reviewed 50 patients with pituitary macroadenoma who received VF test and 11 patients were excluded. VF analysis was performed with Humphrey perimeter using the SITA standard strategy. The tumor volume was assessed radiologically via brain magnetic resonance images and was calculated using Cavalieri's principle. We used the mean deviation (MD) and pattern standard deviation (PSD) of the Humphrey parameter to measure VF defect severity, and then analyzed the correlation of tumor volume with VF defects.

Results: Twenty nine patients (74%) showed abnormal VF and bitemporal field changes, which were the most common field defects on presentation. Seven patients (18%) had unilateral VF defects, 22 patients (56%) had bilateral VF defects. The tumor volume of the patients with VF defects was significantly larger than that of patients with normal VF (p = 0.006). The tumor volume exhibited significant negative correlation with MD (r = -0.693; p < 0.001) and significant positive correlation with PSD (r = 0.589; p < 0.001).

Conclusions: In patients with pituitary macroadenoma, there was a variety of VF defects and a high correlation between the tumor volume and the severity of VF defects. SITA standard strategy can be a fast and quantitative method for evaluating central VF defects.

Show MeSH
Related in: MedlinePlus