tage of improvement in viual field after pituitary tumor reection

PURPOE: To ue tatic threhold perimetry to examine the tage of improvement and the potential for late improvement of viual field after urgical reection of pituitary adenoma cauing viual lo from compreion of the anterior viual pathway. METHOD: Retropective review of chart of patient with pituitary tumor and abnormal tatic threhold perimetry before or oon after treatment who had ubequent viual field. Quantification of the viual field mean deviation overall, uperotemporally, and inferotemporally wa performed and compared between viit. Potoperative viit were conidered in five time period: viit 1 (urgery to 1 week), viit 2 (1 month to 4 month), viit 3 (6 month to 1 year), viit 4 (2 year), and viit 5 (3 or more year). REULT: ixty-two patient were included (33 men and 29 women; mean age 54 year [D ± 15 year; range, 22 to 83 year]). At viit 1, the relative improvement of the overall mean deviation for the right eye wa 30.8% (P = .01) and for the left eye wa 13.7% (P = .3067). At viit 2, the relative improvement of the overall mean deviation for the right eye wa 30.4% (P = .0142) and for the left eye wa 32.6% (P = .0092). At viit 1 and 2, the inferotemporal quadrant were the quadrant with greatet improvement (viit 1, right eye, 37.8% [P = .0082]; viit 2, left eye, 30.8% [P = .0074]). At viit 3, 4, and 5, an overall trend toward mild improvement wa oberved with tatitical ignificance only for the inferotemporal quadrant of the left eye from viit 2 to viit 3, which improved 19.7% (P = .0270). CONCLUION: The pattern of recovery of viual function after decompreion of the anterior viual pathway ugget at leat three phae of improvement. The early fat phae (urgery to 1 week) of improvement may lead to normalization of viual field in ome individual. The early low phae (1 month to 4 month) i the period of mot notable improvement. A late phae (6 month to 3 year) of mild improvement doe not appear ignificant overall but may be marked in ome individual. Each of thee phae may have one or more mechanim underlying the oberved improvement