PDF(Pubmed)
Abstract：
UNASSIGNED: To investigate the long-term visual outcome and their determinants after an operation in Thai pituitary adenoma (PA).
UNASSIGNED: A retrospective cohort study was conducted on PA patients who underwent surgery at Rajavithi Hospital. Baseline characteristics and visual parameters, including visual acuity (VA) and visual field (VF), were analyzed in relation to the visual prognosis outcome. The outcome was defined as VA improvement at 1-year postoperatively. Visual parameters were measured at each follow-up visit and compared. Factors for improved visual prognosis were evaluated using logistic regression analysis.
UNASSIGNED: A total cohort of 87 patients (64.37% female), 62.07% showed improvement in visual outcome. Most improvement occurred immediately after surgery, evident at the 1-month visit. The mean follow-up time was 47.45 months (±28.49 SD), mean difference in VA improvement at 1-year was -0.56 logMAR (95% CI -0.73, -0.47). In multivariable logistic regression model, prolonged onset duration was associated with a reduced odds of improved visual outcome, with an odds ratio (OR) of 0.946 (95% CI 0.899-0.996, p = 0.034). Baseline characteristics, tumor volume, Hardy and Knops classification, and surgical approaches were not identified as significant predictors.
UNASSIGNED: Both TSS and transcranial approaches are effective for pituitary adenoma. A prompt operation is recommended for patients with prolonged onset duration, with thorough discussion on poor postoperative visual outcomes.
UNASSIGNED: A retrospective cohort study was conducted on PA patients who underwent surgery at Rajavithi Hospital. Baseline characteristics and visual parameters, including visual acuity (VA) and visual field (VF), were analyzed in relation to the visual prognosis outcome. The outcome was defined as VA improvement at 1-year postoperatively. Visual parameters were measured at each follow-up visit and compared. Factors for improved visual prognosis were evaluated using logistic regression analysis.
UNASSIGNED: A total cohort of 87 patients (64.37% female), 62.07% showed improvement in visual outcome. Most improvement occurred immediately after surgery, evident at the 1-month visit. The mean follow-up time was 47.45 months (±28.49 SD), mean difference in VA improvement at 1-year was -0.56 logMAR (95% CI -0.73, -0.47). In multivariable logistic regression model, prolonged onset duration was associated with a reduced odds of improved visual outcome, with an odds ratio (OR) of 0.946 (95% CI 0.899-0.996, p = 0.034). Baseline characteristics, tumor volume, Hardy and Knops classification, and surgical approaches were not identified as significant predictors.
UNASSIGNED: Both TSS and transcranial approaches are effective for pituitary adenoma. A prompt operation is recommended for patients with prolonged onset duration, with thorough discussion on poor postoperative visual outcomes.
摘要：
■研究泰国垂体腺瘤（PA）手术后的长期视力结果及其决定因素。
■对在Rajavithi医院接受手术的PA患者进行了一项回顾性队列研究。基线特征和视觉参数，包括视敏度(VA)和视野(VF)，分析了与视觉预后结果的关系。结果定义为术后1年的VA改善。在每次随访时测量视觉参数并进行比较。使用逻辑回归分析评估改善视觉预后的因素。
■总共87名患者（64.37%为女性），62.07%视力改善。大多数改善发生在手术后立即，在为期一个月的访问中显而易见。平均随访时间为47.45个月(±28.49SD),1年时VA改善的平均差异为-0.56logMAR(95%CI-0.73,-0.47).在多变量逻辑回归模型中，延长发作持续时间与改善视力结果的几率降低相关，比值比（OR）为0.946（95%CI0.899-0.996，p=0.034）。基线特征，肿瘤体积,Hardy和Knops分类，和手术入路未被确定为重要的预测因素。
■TSS和经颅入路对垂体腺瘤均有效。对于发病持续时间较长的患者，建议进行及时的手术，对术后视力不良进行了深入的讨论。
■对在Rajavithi医院接受手术的PA患者进行了一项回顾性队列研究。基线特征和视觉参数，包括视敏度(VA)和视野(VF)，分析了与视觉预后结果的关系。结果定义为术后1年的VA改善。在每次随访时测量视觉参数并进行比较。使用逻辑回归分析评估改善视觉预后的因素。
■总共87名患者（64.37%为女性），62.07%视力改善。大多数改善发生在手术后立即，在为期一个月的访问中显而易见。平均随访时间为47.45个月(±28.49SD),1年时VA改善的平均差异为-0.56logMAR(95%CI-0.73,-0.47).在多变量逻辑回归模型中，延长发作持续时间与改善视力结果的几率降低相关，比值比（OR）为0.946（95%CI0.899-0.996，p=0.034）。基线特征，肿瘤体积,Hardy和Knops分类，和手术入路未被确定为重要的预测因素。
■TSS和经颅入路对垂体腺瘤均有效。对于发病持续时间较长的患者，建议进行及时的手术，对术后视力不良进行了深入的讨论。
