[Pre- and postoperative eye findings in hypophyseal adenoma]

When hypophyseal tumours are present, eye symptoms are the leading signs; they indicate, however, an advanced tumour stage. On the basis of 274 histologically verified hypophyseal adenomas, pre- and postoperative ophthalmological findings were analysed. Disturbances of the visual acuity were found preoperatively in 85.4 per cent, scotomas in 86.1 per cent and an optical nerve atrophy in 67.2 per cent of the patients. After neurosurgical intervention, 41.8 per cent of the examined patients showed an improvement of the visual acuity and 59.2 per cent a regression of the scotomas. Optical nerve atrophy was found in 78.1 per cent which was a higher percentage than before the operation. Disturbances of the visual acuity or scotomas that have persisted for a prolonged period of time show, just as optical nerve atrophy, a more unfavourable prognosis. So it had to be the aim of a neurosurgical treatment to diagnose the pituitary adenoma at an early time in order to improve the chances of a success. Eosinophilic hypophyseal adenomas are more easily recognisable, because of acromegalia being present in almost all cases. Ophthalmologically, they show less scotomas since they reach the dimensions of the chromophobic or mixed type adenomas only rarely. When blindness has developed, the situation is very serious since only in exceptional cases a recovery of sight is possible.