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Updated: Nov 23, 2025
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Good Visual Outcomes After Pituitary Tumor Surgery Are Associated With Increased Visual Cortex Functional
Stefan T Lang1, Won Hyung A Ryu, Yves P Starreveld
1Division of Neurosurgery (STL, WHAR, YPS), Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Division of Ophthalmology (FEC), Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada; Division of Neurology (FEC), Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Neurological Surgery (WHAR), Rush University, Chicago, IL; and Hotchkiss Brain Institute (STL, FEC), University of Calgary, Calgary, Canada.
Resting-state functional MRI (rsfMRI) can distinguish good versus poor visual outcomes after pituitary tumor surgery. Increased visual cortex connectivity in patients with pituitary macroadenomas correlates with better vision recovery.
Area of Science:
- Neuroscience
- Radiology
- Ophthalmology
Background:
- Pituitary macroadenomas can cause visual impairment with variable surgical recovery.
- Neuroaxonal damage and cortical plasticity influence visual outcomes.
- Optical coherence tomography (OCT) and resting-state functional MRI (rsfMRI) assess visual pathway integrity and brain adaptation.
Purpose of the Study:
- To determine if rsfMRI functional connectivity (FC) patterns differentiate good (GO) versus poor (PO) visual outcomes post-pituitary adenoma surgery.
- To evaluate the role of cortical adaptation in visual recovery after pituitary tumor decompression.
Main Methods:
- Retrospective cohort study comparing FC in GO (n=21) versus PO patients and healthy controls (HCs, n=19).
- Postoperative rsfMRI analyzed seed-based connectivity of visual cortex regions (V1, V2, V5) at least 1 year after surgery.
- Demographics, visual function, and OCT data were compared between groups.
Main Results:
- GO patients exhibited increased postoperative visual system FC compared to PO patients.
- Good visual outcomes were linked to enhanced connectivity of right V5 to frontal cortices.
- GO patients showed altered visual cortex connectivity with sensorimotor and prefrontal cortices compared to HCs.
Conclusions:
- Increased visual cortex connectivity is associated with good visual outcomes in the late recovery phase after pituitary tumor surgery.
- rsfMRI effectively distinguishes between good and poor visual outcomes post-surgery.
- This imaging technique may help characterize cortical adaptation's impact on visual recovery.
