Objective: Describe the outcome of visual disorders after endonasal transsphenoidal (EET) surgery of pituitary macroadenomas with preoperative chiasmal compression. Patients and Methods: From 2009 to 2013, 225 patient...Objective: Describe the outcome of visual disorders after endonasal transsphenoidal (EET) surgery of pituitary macroadenomas with preoperative chiasmal compression. Patients and Methods: From 2009 to 2013, 225 patients underwent EET surgery for sellar tumor. Among them, 168 suffered from visual disorders induced by chiasmatic compression, of which 88 met the inclusion criteria for this study. Average duration of follow up was 1.8 yrs ± 0.4 yrs. All patients had sellar MRI before surgery and yearly postoperatively, visual acuity (VA) and/or visual field (VF) measurements before, 3 months after surgery and yearly postoperatively. Results: All tumors were macroadenomas with a mean preoperative MRI-estimated volume of 10.0 {plus minus} 9.07 cm<sup>3</sup>. Preoperative VA was impaired with an average of 0.43 ± 0.13 LogMAR (left eye) and 0.36 ± 0.14 LogMAR (right eye) and VF was disturbed in 99% ± 2% of the cases with the most frequent disorder being bitemporal hemianopsia (38 patients). Post-operatively, the mean residual MRI-estimated tumor volume was 3.15 ± 3.71 cm<sup>3</sup>. Mean tumor volume reduction was 62% ± 9% (p < 0.001). Optic chiasmal compression resolved in 72% ± 10% of the cases. Visual function improved in 86% ± 7% of cases (p < 0.001). Conclusion: Endoscopic endonasal management of pituitary gland neoplasms is effective to reduce tumor volume. This technique achieved significant visual improvement in the majority of cases presenting with chiasmal compression syndrome.展开更多
Purpose:The authors accumulated 15cases(26eyes)of steroid glaucoma due to topical administration of dexamethasone or prednisolone.Methods:From1970to 1990,26eyesin 15cases were observed(Bilateral11cas-es,unilateral4cas...Purpose:The authors accumulated 15cases(26eyes)of steroid glaucoma due to topical administration of dexamethasone or prednisolone.Methods:From1970to 1990,26eyesin 15cases were observed(Bilateral11cas-es,unilateral4cases)including 12right eyes and 14left eyes.10cases were male and 5cases female with age ranging from14to52years averaging 28years.25eyes had the manifestation of chronic open angle glaucoma in the clinical coures,and 1eye simulated an acute glaucoma attack.Results:All patents had taken antiglaucoma medication before coming to our ohs-pital,but theIOPwas over6.7kPa in9eyes.TheC/Dration was equal to or over0.6in 9cases(16eyes).and the values were inconsistent between both eyes in 55%of the patients.Treatment for glaucoma was immediate discontinuation of the steroids with antiglaucoma medication if necessary.Three eyes received filter-ing operations and 2eyes had the removal of subconjunctival residual steroid.Normal IOPwas restored in monyths up to a year.Conclusion:Dexamethasone of prednisolone were the easiest to induce steroid glaucoma when the patients had long0term use of steroid eyedrops.展开更多
文摘Objective: Describe the outcome of visual disorders after endonasal transsphenoidal (EET) surgery of pituitary macroadenomas with preoperative chiasmal compression. Patients and Methods: From 2009 to 2013, 225 patients underwent EET surgery for sellar tumor. Among them, 168 suffered from visual disorders induced by chiasmatic compression, of which 88 met the inclusion criteria for this study. Average duration of follow up was 1.8 yrs ± 0.4 yrs. All patients had sellar MRI before surgery and yearly postoperatively, visual acuity (VA) and/or visual field (VF) measurements before, 3 months after surgery and yearly postoperatively. Results: All tumors were macroadenomas with a mean preoperative MRI-estimated volume of 10.0 {plus minus} 9.07 cm<sup>3</sup>. Preoperative VA was impaired with an average of 0.43 ± 0.13 LogMAR (left eye) and 0.36 ± 0.14 LogMAR (right eye) and VF was disturbed in 99% ± 2% of the cases with the most frequent disorder being bitemporal hemianopsia (38 patients). Post-operatively, the mean residual MRI-estimated tumor volume was 3.15 ± 3.71 cm<sup>3</sup>. Mean tumor volume reduction was 62% ± 9% (p < 0.001). Optic chiasmal compression resolved in 72% ± 10% of the cases. Visual function improved in 86% ± 7% of cases (p < 0.001). Conclusion: Endoscopic endonasal management of pituitary gland neoplasms is effective to reduce tumor volume. This technique achieved significant visual improvement in the majority of cases presenting with chiasmal compression syndrome.
文摘Purpose:The authors accumulated 15cases(26eyes)of steroid glaucoma due to topical administration of dexamethasone or prednisolone.Methods:From1970to 1990,26eyesin 15cases were observed(Bilateral11cas-es,unilateral4cases)including 12right eyes and 14left eyes.10cases were male and 5cases female with age ranging from14to52years averaging 28years.25eyes had the manifestation of chronic open angle glaucoma in the clinical coures,and 1eye simulated an acute glaucoma attack.Results:All patents had taken antiglaucoma medication before coming to our ohs-pital,but theIOPwas over6.7kPa in9eyes.TheC/Dration was equal to or over0.6in 9cases(16eyes).and the values were inconsistent between both eyes in 55%of the patients.Treatment for glaucoma was immediate discontinuation of the steroids with antiglaucoma medication if necessary.Three eyes received filter-ing operations and 2eyes had the removal of subconjunctival residual steroid.Normal IOPwas restored in monyths up to a year.Conclusion:Dexamethasone of prednisolone were the easiest to induce steroid glaucoma when the patients had long0term use of steroid eyedrops.
