Predictive factors of visual function recovery after pituitary adenoma resection： a literature review and Meta-analysis

• Published in: International journal of ophthalmology Vol. 10; no. 11; pp. 1742 - 1750
• Main Authors: Sun, Min, Zhang, Zhi-Qiang, Ma, Chi-Yuan, Chen, Sui-Hua, Chen, Xin-Jian
• Format: Journal Article
• Language: English
• Published: China International Journal of Ophthalmology Press 18.11.2017; Press of International Journal of Ophthalmology (IJO PRESS)
• Subjects: 1750; Meta-Analysis; pituitary adenoma; retinal thickness; visual field defect; visual function recovery prediction; retinal thickness; pituitary adenoma; visual field defect; visual function recovery prediction
• ISSN: 2222-3959; 2227-4898
• DOI: 10.18240/ijo.2017.11.17

AIM：To determine the dominant predictive factors of postoperative visual recovery for patients with pituitary adenoma.METHODS：Pub Med,Google Scholar,Web of Science and Cochrane Library were searched for relevant human studies,which investigated the prediction of the postoperative visual recovery of patients with pituitary adenoma,from January2000 to May 2017.Meta-analyses were performed on the primary outcomes.After the related data were extracted by two independent investigators,pooled weighted mean difference（WMD）and odds ratio（OR）with 95%confidence interval（CI）were estimated using a random-effects or a fixed-effects model.RESULTS：Nineteen studies were included in the literature review,and nine trials were included in the Metaanalysis,which comprised 530 patients（975 eyes）with pituitary adenoma.For the primary outcomes,there was a significant difference between preoperative and postoperative mean deviation（MD）values of the visual field（WMD-5.85;95%CI：-8.19 to-3.51;P〈0.00001）.Predictivecharacteristics of four factors were revealed in this Metaanalysis by assigning the patients to sufficient and insufficient groups according to postoperative visual field improvements,including preoperative visual field defect（WMD 10.09;95%CI：6.17 to 14.02;P〈0.00001）,patient age（WMD-12.32;95%CI：-18.42 to-6.22;P〈0.0001）,symptom duration（WMD-5.04;95%CI：-9.71 to-0.37;P=0.03）,and preoperative peripapillary retinal nerve fiber layer（p RNFL）thickness（OR 0.1;95%CI：0.04 to 0.23;P〈0.00001）.CONCLUSION：Preoperative visual field defect,symptom duration,patient age,and preoperative p RNFL thickness are the dominant predictive factors of the postoperative recovery of the visual field for patients with pituitary adenoma.