Guevara-Dondé JE

Language: Spanish
References: 10
Page: 58-62
PDF size: 93.74 Kb.

ABSTRACT

The high pituitary macroadenoma present, acute visual reduction in 89% and 58% visual field reduction. In this moment is not possible determinate, after tumoral resection, the visual function pronostic. Thirty seven patients with pituitary macroadenoma diagnosis and previous optic way affection who were treated surgically by transsphenoidal or transcranial approach were studied. Fourteen men and twenty three women among twenty and fourty years age. Sixty seven percent patients had important reduction of acuity arid visual fields. Only thirty three percent had classic bitemporal hemianopsia. A subtotal resection were realizated in four patients and second surgery was necessary. All of them were studied for five years after initial surgery. Three patients presented recurrence in this time. The outcome surgery were: visual field improvement in seventeen patients (45%) normal visual fields in six patients (18%) and without change in fourteen (37%). In visual acuity: Improvement in twenty four patients (67%) and total recovery in six patients (14%). In conclusion in the finish results, was obtained improvement in 63% for visual fields and 81.2% for acute visual. The results depend according to various factors, like: The evolution time of symptoms, grade of the optic way affection, a compression tolerance, neoplasm magnitude and quantity of pituitary tumor resection.

REFERENCES

1. González-Almaraz G, Piñeda-Cárdenas MA. Craneofaringioma papilar. Presentación de un caso con compromiso quiasmático. Rev Mex Oftal 1995; 69: 91-99.

2. Loyo M, Del Valle R, Zárate A. Cirugía transesfenoidal en el tratamiento del adenoma pituitario en 500 abordajes En: Libro homenaje al Dr. Manuel Velasco Suárez. Rodríguez C, Escobar I, editores, México: Editorial Progreso SA; 1989: 490-498.

3. Guevara DJ, Vera PM, Santillán GM. Lesiones de la vía óptica. Rev Med IMSS 1993; 31: 351-354.

4. Puig SM. Papel del oftalmólogo en el diagnóstico de las lesiones quiasmáticas. An Soc Mex Oftal 1963; 36: 219.

5. Loyo M, Kleriga E, Mateos JH, De Leo R, Delgado A. Combined supra-infrasellar approach for large pituitary tumors. Neurosurgery 1984; 14: 485-488.

6. Puig SM, Ramírez A, Del Cueto R. Resultados visuales de la terapéutica quirúrgica en los procesos directamente compresivos de la región quiasmática. An Soc Mex Oftal 1954; 27: 98.

7. Guevara DJ, Martínez CD, Santillán GM. Acceso transcraneal subfrontal para el tratamiento quirúrgico de las lesiones periquiasmáticas. Rev Mex Oftal 1995; 69: 105-108.

8. Durand O, Gómez AA, Pane PC. Resección endoscópica transnasal de adenoma hipofisario: técnica quirúrgica. Rev Orn Mex 1996; 41: 95-97.

9. Watanabe H. Role of the ophthalmologist in diagnosing brain tumor. South Med J 1973; 66: 1101-1107.

10. Sullivan LJ. Visual outcomes of pituitary adenoma surgery. J Clin Neuro Ophthalmology 1991; 11: 262.