Objective: The natural history of non-functioning pituitary macroadenomas (NFMA) has not been completely elucidated. Therefore, we evaluated pituitary function, visual fields, and tumor size during long-term follow-up of non-operated patients with NFMA. Design: Follow-up study. Patients: Twenty-eight patients (age 55G3 years) with NFMA, not operated after initial diagnosis, were included. Results: Initial presentation was pituitary insufficiency in 44%, visual field defects in 14%, apoplexy in 14%, and chronic headache in 7% of the patients. The duration of follow-up was 85G13 months. Radiological evidence of tumor growth was observed in 14 out of 28 patients (50%) after duration of follow-up of 118G24 months. Six patients (21%) were operated, because tumor growth was accompanied by visual field defects. Visual impairments improved in all the cases after transsphenoidal surgery. Spontaneous reduction in tumor volume was observed in eight patients (29%). No independent predictors for increase or decrease in tumor volume could be found by regression analysis. Conclusion: Observation alone is a safe alternative for transsphenoidal surgery in selected NFMA patients, without the risk of irreversibly compromising visual function. European Journal of Endocrinology 156 217-224

Objective Improvement of visual field defects continues even years after the initial surgical treatment. Because this process of continuing improvement has not been documented for visual acuity, we audited our data to explore the pattern of recovery of visual acuity until 1 year after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. Design Retrospective follow-up study. Patients Forty-three patients (mean age 56 ± 14 years), treated by transsphenoidal surgery for non-functioning pituitary macroadenoma, were included in this analysis. Results Visual acuity improved significantly within 3 months after transsphenoidal surgery. The mean visual acuity increased from 0.65 ± 0.37 to 0.75 ± 0.36 (P < 0.01) (right eye), and from 0.60 ± 0.32 to 0.82 ± 0.30 (P < 0.01) (left eye). Visual acuity was improved 1 year after transsphenoidal surgery compared to the 3 months postoperative values. The mean visual acuity increased from 0.75 ± 0.36 to 0.82 ± 0.34 (P < 0.05) (right eye), and from 0.82 ± 0.30 to 0.88 ± 0.27 (P < 0.05) (left eye). Conclusion Visual acuity improves progressively after surgical treatment for non-functioning pituitary macroadenomas, at least within the first year after transsphenoidal surgery.

Aims: To establish the relationship between exophthalmos and obesity. Methods: A group of 19 obese patients (body mass index, BMI ≧30 kg/m²) was compared with a control group of 45 nonobese individuals (26 > BMI ≧ 20 kg/m²). Both groups underwent Hertel’s exophthalmometry, Goldmann applanation tonometry and measurement of the medial rectus muscle by echography. Results: Obese patients had higher Hertel values and enlarged medial rectus muscle diameter (p < 0.05). Indeed, bilateral exophthalmos was observed in 33% of obese subjects. However, this did not cause any ocular morbidity. In some cases the difference in intraocular pressure was enlarged but together with the exophthalmos not statistically significant. Conclusions: Standard values for exophthalmometry and orbital echography may have to be adapted for obese individuals. In several cases the eye signs had a remarkable resemblance to patients with Graves’ orbitopathy. So in each patient with bilateral exophthalmos and eye signs suspicious of Graves’ orbitopathy obesity should be considered as a possible cause.

Biopore cytology can be used for cytologic sampling of conjunctival melanocytic lesions. Because of the larger amount and higher density of cells obtained with the Biopore membrane, interpretation by a pathologist is easier and faster. Sampling of the fornix, caruncula, and ocular material in children is difficult with the Biopore method, and exfoliative cytology seems to be the favorable test in those situations.

If radical surgery for angiosarcoma of the eyelid and periorbital region is not possible, adjuvant iridium(192) wire brachytherapy may prove beneficial. For widespread, diffusely growing tumors, and in elderly patients, low-dose (slowly, 20 mg i.v.) doxorubicin can be used weekly as adjuvant therapy, resulting in partial regression and longer survival rates than previously published by other authors.

effects of antiprogestrones on human meningioma cells in vitro and in vivo.

This erosive sino-orbital inflammatory myofibroblastic tumor is a novel finding mimicking a malignant tumor.

Purpose To evaluate the influence of smoking on comorbidity, treatment, visual and general outcome in patients with scleritis.