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Predictive model for recovery of visual field after surgery of pituitary adenoma

 Junwon Lee  ;  Seung Woo Kim  ;  Dong Wook Kim  ;  Joo Youn Shin  ;  Moonjung Choi  ;  Min Chul Oh  ;  Seung Min Kim  ;  Eui Hyun Kim  ;  Sun Ho Kim  ;  Suk Ho Byeon 
 JOURNAL OF NEURO-ONCOLOGY, Vol.130(1) : 155-164, 2016 
Journal Title
Issue Date
Adenoma/surgery* ; Adult ; Cohort Studies ; Diagnostic Techniques, Ophthalmological ; Female ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurosurgery/methods* ; Nomograms ; Pituitary Neoplasms/surgery* ; Predictive Value of Tests ; Recovery of Function/physiology* ; Retina/pathology ; Visual Field Tests ; Visual Fields/physiology*
Nomogram ; Pituitary adenoma ; Visual field
Visual field defect is a major indication for surgery of pituitary adenoma, but visual outcome after surgery is difficult to predict. We developed a nomogram that predicts postoperative restoration of visual field defects in patients with pituitary adenoma. This study was a retrospective cohort investigation of patients who were treated for pituitary adenoma between January 2009 and December 2013. We enrolled 111 eyes of 57 patients who completed one ophthalmological evaluation preoperatively and at least two evaluations within 6 months after surgery. Serial changes in visual fields and retinal nerve fiber layer (RNFL) thickness were evaluated. Multiple logistic regression analysis was performed to select prognostic variables, and a nomogram to predict restoration of visual field defects was constructed. Visual field defects continuously improved until 3 months after surgery. However, average, superior, and inferior RNFL thickness continuously decreased until 6 months after surgery. Multiple logistic regression analysis revealed that worse preoperative visual field defect (p?=?0.018), high MRI compression grade (p?=?0.009), and inferior RNFL thinning (p?=?0.011) were significantly associated with worse visual outcome. The nomogram that predicts the visual restoration showed an area under the receiver operating characteristic curve of 0.84. In conclusion, we developed a nomogram that predicted the restoration of visual field defects after removal of pituitary adenoma. This would allow tailored counseling of individual patients by precisely predicting visual recovery after surgery.
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1. College of Medicine (의과대학) > Dept. of Physiology (생리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Wook(김동욱) ORCID logo https://orcid.org/0000-0002-5025-1532
Kim, Sun Ho(김선호) ORCID logo https://orcid.org/0000-0003-0970-3848
Kim, Seung Min(김승민) ORCID logo https://orcid.org/0000-0002-4384-9640
Kim, Seung Woo(김승우) ORCID logo https://orcid.org/0000-0002-5621-0811
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Byeon, Suk Ho(변석호) ORCID logo https://orcid.org/0000-0001-8101-0830
Lee, Jun Won(이준원) ORCID logo https://orcid.org/0000-0003-0543-7132
Choi, Moonjung(최문정)
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