Visual Outcome of an Endoscopic Endonasal Transsphenoidal Approach in Pituitary Macroadenomas: Quantitative Assessment with Diffusion Tensor Imaging Early and Long-Term Results

Anık, İhsan; Anık, Yonca; Çabuk, Burak; Çaklılı, Melih; Pirhan, Dilara; Öztürk, Onural; Çırak, Musa; Ceylan, Savaş

doi:10.1016/j.wneu.2018.01.134

Cited by 38 publications

(15 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…juga menunjukkan hubungan serupa antara durasi gejala dan kecepatan perbaikan fungsi visual, hal ini diduga berhubungan dengan tingkat remielinisasi yang terjadi pada fase awal pemulihan fungsi visual. 20 Perbaikan fungsi visual setelah dekompresi dihubungkan dengan usia yang lebih muda, durasi gejala yang lebih singkat dan derajat penurunan fungsi visual preoperatif yang lebih baik. 21 Pada peneltian ini usia tidak dihitung.…”

Section: Pembahasanunclassified

Pascaoperasi Adenoma Hipofisis: Hubungan Antara Durasi Awitan Dengan Luaran Klinis Visus Dan Lapang Pandang

Aman

Setiawan

Werdhani

et al. 2020

View full text Add to dashboard Cite

Pendahuluan: Adenoma hipofisis dapat menyebabkan penurunan visus dan penyempitan lapangan pandang. Beberapa penelitian telah menunjukkan bahwa lama keluhan berhubungan secara signifikan dengan hasil klinis. Sebagai rumah sakit pusat rujukan nasional, semua pasien adenoma hipofisis yang datang ke RSUPN Dr. Cipto Mangunkusumo (RSCM) dirujuk dari dokter spesialis mata, ahli saraf, dan ahli bedah saraf dari institusi lain. Tujuan: Dalam penelitian ini, kami meneliti hubungan antara durasi, yang dihitung dari saat gejala pertama kali muncul ke waktu operasi, dan hasil visus dan lapang pandang pada pasien adenoma hipofisis yang menjalani operasi transfenoidal. Metode: Penelitian ini merupakan penelitian restrospektif pada pasien adenoma hipofisis yang menjalani operasi transsfenoidal antara 2015-2017 di RSCM. Durasi antara awitan gejala dan operasi dihitung dalam bulan. Pemeriksaan visus dan lapang pandang dilakukan 1 hari sebelum operasi dan dalam 1 hingga 2 bulan pascaoperasi. Hasil: Terdapat 71 pasien (36 pria, 35 wanita) dengan penurunan visus dan lapang pandang menyempit, dengan usia rata-rata 42 tahun (20-77 tahun). Durasi rata-rata awitan untuk kedua gejala adalah 12 bulan (1-108 bulan). Sebanyak 40,5% pasien mengalami peningkatan visus pascaoperasi, dengan durasi rata-rata awitan 11 bulan. Peningkatan lapang pandang dialami pada 67,6% pasien, dengan durasi rata-rata awitan 12 bulan. Diskusi: Kesimpulan penelitian terdapat hubungan bermakna secara statistik antara durasi awitan sampai dilakukan tindakan operasi dengan luaran klinis lapang pandang. Perbaikan lapang pandang didapatkan pada pasien yang memiliki durasi awitan sampai dilakukan tindakan operasi sampai dengan 12 bulan. Kata kunci: Adenoma hipofisis, lapang pandang, operasi transfenoidal, visus

show abstract

Section: Pembahasanunclassified

Pascaoperasi Adenoma Hipofisis: Hubungan Antara Durasi Awitan Dengan Luaran Klinis Visus Dan Lapang Pandang

Aman

Setiawan

Werdhani

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Visual recovery after transsphenoidal surgery occurs in various phases. Initial improvement may be rapid within minutes to a few days (7, 51, 52) but additional significant changes may continue over a longer time frame (months) (7,29,52,53). The majority of studies are retrospective chart reviews where arbitrary time points were chosen for analysis.…”

Section: Timing Mechanisms and Predictors Of Visual Improvement Aftementioning

confidence: 99%

“…The majority of studies are retrospective chart reviews where arbitrary time points were chosen for analysis. Anik et al (52) assessed visual recovery (visual fields and acuity) following transsphenoidal surgery in 200 patients. The percentage with full recovery of vision increased by 7% between 48 h and 6 months, by 17% between 6 months and 1 year and by 2% beyond 1 year.…”

Section: Timing Mechanisms and Predictors Of Visual Improvement Aftementioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Visual morbidity in patients with pituitary adenoma

Lithgow

Batra

Matthews

et al. 2019

European Journal of Endocrinology

View full text Add to dashboard Cite

Visual dysfunction is an important element in the morbidity encountered in patients with pituitary adenoma leading to functional impairment and compromised quality of life. It consists of many parameters (even in the absence of reported symptomatology) as a result of tumour growth in proximity to structures critical for vision (anterior visual pathway, cranial nerves within cavernous sinuses), and as an adverse consequence of therapeutic interventions. Adenoma resection leads to high rates of visual improvement and possibly continues beyond a year post surgery, but the exact timing of maximum effect requires elucidation. Retinal nerve fibre layer measurement may be a reliable, objective parameter predicting favourable visual outcomes, although its prognostic value when pathological, needs to be confirmed. For compromised vision after pituitary apoplexy, early surgical decompression remains usual practice until evidence-based guidance becomes available. The risk of radiation-induced visual toxicity is mainly influenced by total and per fraction dose of radiation and treatment modality. Careful selection of cases and of radiotherapy technique/planning are of major importance in minimising this risk. Dopamine agonists lead to visual recovery in a considerable number of prolactinoma patients. Visual morbidity should be considered a vital indicator in the metrics of quality of service/care in pituitary disease making regular, full ophthalmic examination an essential component of modern management of pituitary pathology at all time points of patient pathway. Well-designed studies minimising effects of bias and using tools and scoring systems reliably reflecting visual status will provide robust evidence on valid prognostication and patient stratification guiding clinical decision making.

show abstract

“…Em uma meta-análise avaliando o resultado visual após cirurgia transesfenoidal de adenomas de hipófise, Muskens e colaboradores (92) mostraram melhora visual completa em 40,4% dos pacientes com defeitos de CV. A melhora da função visual ocorre geralmente nas duas primeiras semanas e poderia estar relacionada a duração dos sintomas, sendo observado em alguns estudos que pacientes operados com menos de 6 meses de história apresentariam mais chance de recuperação do que aqueles com sintomas por longo período (93,94) .…”

Section: Tratamento Recuperação Visual E Seguimentounclassified

“…Alguns estudos com IRM associam maior tamanho da lesão com piores prognósticos visuais, uma das hipóteses é que tumores maiores estariam associados a outros fatores como maior tempo de compressão e lesões axonais mais extensas (96,97) . Outros estudos associam ainda as imagens por difusão da IRM com a chance de recuperação visual (93) . Um estudo recente mostrou correlação da degeneração do corpo geniculado lateral através de medidas baseadas na IRM e o prognóstico visual dos pacientes com compressão quiasmática submetidos a cirurgia.…”

Section: Tratamento Recuperação Visual E Seguimentounclassified

Correlação entre a densidade capilar da retina peripapilar e macular medidas com a angiotomografia de coerência óptica e as medidas de espessura retiniana e campimetria visual em olhos com atrofia em banda do nervo óptico

Suzuki¹

View full text Add to dashboard Cite

Purpose: To compare the circumpapillary and superficial macular vessel density (cpVD and mVDsup) of eyes with temporal visual field (VF) defect and band atrophy (BA) of the optic nerve and normal controls using optical coherence tomography angiography (OCTA) and to verify the association of vessel density parameters with retinal neural loss assessed by conventional optical coherence tomography (OCT) and VF loss. Methods: Thirty-three eyes of 26 patients with BA and 42 eyes of 22 age-matched normal controls underwent OCT + OCTA scanning. cpVD and circumpapillary retinal nerve fiber layer (cpRNFL) thickness were expressed as average and sector measurements. mVDsup and macular ganglion cell complex (mGCC) thickness were calculated as averages and in quadrants and hemiretinas. VF loss was estimated using the 24-2 and the 10-2 protocols. Results: Compared with controls, BA eyes displayed smaller average cpVD and mVDsup values (p < 0.001 and AROC = 0.91 for both). Sectorial measurements were also reduced, especially the nasotemporal sector average cpVD (p < 0.001 and AROC = 0.96) and the nasal inferior retina mVDsup measurements (p < 0.001 and AROC = 0.93). cpVD and mVDsup correlated strongly (p<0,001) with corresponding cpRNFL and mGCC thickness measurements in affected regions (r range: 0.67-0.78 and 0.56-0.76, respectively). Similarly, cpVD and mVDsup parameters correlated significantly with corresponding VF loss (r range: 0.45-0.68). Conclusion: cpVD and mVDsup are significantly reduced in BA eyes compared with controls and are strongly correlated with retinal neural and VF loss. cpVD and mVDsup reduction on OCTA could serve as a surrogate for retinal neural loss in compressive optic neuropathy and might be useful in its management.

show abstract

Visual Outcome of an Endoscopic Endonasal Transsphenoidal Approach in Pituitary Macroadenomas: Quantitative Assessment with Diffusion Tensor Imaging Early and Long-Term Results

Cited by 38 publications

References 36 publications

Pascaoperasi Adenoma Hipofisis: Hubungan Antara Durasi Awitan Dengan Luaran Klinis Visus Dan Lapang Pandang

Pascaoperasi Adenoma Hipofisis: Hubungan Antara Durasi Awitan Dengan Luaran Klinis Visus Dan Lapang Pandang

MANAGEMENT OF ENDOCRINE DISEASE: Visual morbidity in patients with pituitary adenoma

Correlação entre a densidade capilar da retina peripapilar e macular medidas com a angiotomografia de coerência óptica e as medidas de espessura retiniana e campimetria visual em olhos com atrofia em banda do nervo óptico

Contact Info

Product

Resources

About