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Visual field defects in 23 acromegalic patients.

Emrah Kan1, Elif Kilic Kan, Aysegul Atmaca

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Pituitary adenomas can cause vision problems, even with normal visual field tests. Larger tumor volumes correlate with visual field defects in acromegaly patients.

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Area of Science:

  • Neuro-oncology
  • Ophthalmology
  • Endocrinology

Background:

  • Pituitary tumors are common intracranial neoplasms.
  • Somatotroph proliferation causes acromegaly due to growth hormone overproduction.
  • Typical visual field defects in pituitary adenomas include bitemporal hemianopsia, but variations exist.

Purpose of the Study:

  • To investigate the relationship between pituitary tumor volume and visual field defects in acromegaly patients.
  • To determine if visual field examination is always indicative of optic pathway compression.

Main Methods:

  • Retrospective review of 23 acromegalic patients with pituitary adenomas.
  • Visual field (VF) testing using Humphrey field analyzer.
  • Pituitary tumor volume calculation using Cavalieri's principle.

Main Results:

  • 65.2% of patients had normal visual fields.
  • Visual field defects included quadrantanopsia and hemianopsia.
  • Patients with visual field defects had significantly larger tumor volumes than those with normal VFs (p=0.02).
  • Some patients with normal VFs had suprasellar masses affecting the optic chiasm.

Conclusions:

  • Pituitary tumor volume is a significant factor in the development of visual field defects.
  • Neuroimaging assessments are crucial, even in patients with normal visual fields.
  • Acromegaly patients with pituitary adenomas require careful visual field monitoring.