The Volume of Tumor Mass and Visual Field Defect in Patients with Pituitary Macroadenoma

Abstract

PurposeWe 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.MethodsWe 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.ResultsTwenty 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).ConclusionsIn 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.

Pituitary Adenoma- Visual Fields, Retinal Nerve Fibre Layer and Ganglion Cell-Inner Plexiform Layer Thickness Analysis- A Correlational Study

“…Similar findings were seen by Meenakshi Y. D et al 5 Bitemporal hemianopia was the predominant field defect in a similar study by Jung Pil Lee et al 7 Bitemporal hemianopia could not be demonstrated to be most common field defect in our study. The probable reason might be that some patients were already on medical treatment for the tumour that might have contributed to regression of the defect.…”

“…PSD shows the pattern of a localised abnormality. 7 Both of the parameters are expressed numerically, so those are useful to quantify the VF defects more accurately.MD and PSD values obtained from the automated perimetry chart showed significant difference when compared to controls. MD was worse than that in the control group (-8.18 ± 8.65 dB vs. -2.0 ± 1.8 dB) and PSD values were higher than controls (5.76 ± 4.8 dB vs. 1.9 ± 1.0 dB).…”

Factors Affecting Visual Field Outcome Post-Surgery in Sellar Region Tumors: Retrospective Study

“…AP being the standard of practise for VF assessment is an automated testing which uses computer algorithm (25). AP is independent of the examiner and conducted by computer in a standard manner making it ideal to follow up patients VF with this method.…”

“…This value is crucial to see the changes of VF defect over time and signifies overall abnormality of a single VF. One of the factor that was found to be correlated with preoperative severity of the VF deficit is tumor volume (25).…”

“…VF on the other hand gives a better idea of an overall abnormality of the vision. This is best depicted by MD value through automated perimetry (25). pituitary stalk, and hypothalamus which also lies in this region could lead to significant neuro endocrinological morbidity when affected (2,3).…”