Clinico-radiological factors affecting visual recovery in pituitary tumours

Abstract

Objectives: It is a prospective, single institute, observational study: primary outcome measure; factors determining visual field improvement and secondary outcome measure; the relationship between severity of visual impairment and duration of symptoms.
 Material and Methods: It is a prospective, single institute, observational study that will be conducted between January 2020 and January 2022 in the department of Neurosurgery at the G. R. Medical College &J.A. Group of Hospitals, Gwalior(M.P.), a tertiary centre in India. All patients were admitted to the neuro-surgery department & operated on basis of a CT Scan of head/MRI findings. Patients with Laboratory findings having hypopituitarism, diabetes insipidus (DI), and hyperprolactinemia and willing to undergo Endocrinological & visual field tests in inclusion criteria. Data obtained from the study will be analyse by using appropriate statistical tests or methods
 Results: At present, series most common age presentation (36.7%) between 21-30 years. In our study, of the total patients, 60% were males and 40% were females. The male to female ratio is 2:1 most common complaint of vision loss and only 50% had hormonal symptoms. In our study 46.7% patients have duration of symptoms < 6 months and 6/6 - 6/24 visual acuity was present in 73.3% patients & 13.3% had optic atrophy(primary/secondary), 43.3%patients had bi-temporal hemianopia.
 In our study Suprasellar extension was present in 90% of patients & Vascular invasion was seen in 26.7% of patients.
 Conclusion: Good results are seen in patients who have a lesser duration of symptoms, and good pre-operative visual acuity has improved the final visual outcome. Post-operative visual recovery is most promising after 3 months to 1 year of surgery. immediate results of visual recovery should not be expected. Most patients presented with larger adenomas had poor visual recovery as compared to small adenomas. Patients who underwent endoscopic trans-nasal, trans-sphenoidal resection had better post-operative recovery.