Tumour characteristics influencing visual field outcomes
Reviewed by Lauren Hepworth

This retrospective study aimed to explore correlations between pituitary tumour characteristics which influenced visual field changes. Cases of transsphenoidal surgery from a six-year period resulting in a pathologic diagnosis of pituitary adenoma from a single centre were identified. Individuals were included in the analysis if optical coherence tomography (OCT) and a visual field assessment (30-2 SITA) were performed pre- and post-surgery. Those without bitemporal hemianopia pre- or post-surgery were excluded. The maximum length and type (solid or cystic) of the tumour were extracted from medical records. A total of 18 individuals (32 eyes) were included. Correlations were found between postoperative visual field mean deviation and the maximum tumour length, which were positive in the multivariate regression and negative in the univariate regression. The preoperative visual acuity and visual field mean deviation were found to be significantly better in solid vs. cystic tumours. However, significantly more improvement was seen in the visual field mean deviation postoperatively in cystic tumours. The maximum tumour length was also significantly larger in cystic tumours. Therefore, the visual field defects caused by cystic tumours demonstrated greater improvement despite being larger tumours. This suggests visual field defects with cystic tumours are more likely to recover postoperatively. The authors hypothesise this may be due to rapid growth and earlier treatment associated with cystic tumours. The following study limitations are acknowledged: small sample size, the ganglion call complex was not analysed and the time between symptom onset and surgery was not adjusted for. This study allows some prognostic indications to be provided based on tumour type.

Influence of tumor characteristics on visual field outcomes after pituitary adenoma surgery.
Ito M, Suda K, Nakano E, et al.
JOURNAL OF NEURO-OPHTHALMOLOGY
2023;43:376–82.