Incidence of neuro-ophthalmic manifestations of pituitary adenomas in the referral area of Linkoping, Sweden, 1965–1984

Abstract

Visual complications of pituitary adenomas in a referral area of almost 1 million inhabitants were studied during a period of 20 years (1965-1984). Out of 204 patients operated on for pituitary adenomas 125 cases presented visual dysfunction. An increase in cases with visual impairment took place in the late 1960's and early 1970's, probably as a consequence of extended ophthalmological services at that time. From 1975 to 1985 the incidence of neuro-ophthalmic manifestations of pituitary adenomas was stable at around 0.8 per 100000 inhabitants per year, with the introduction of modern endocrinological diagnostics and computed tomography having no apparent influence.

A prospective study of 60 patients with ocular manifestations from 1977 to 1985 showed that the predominant type was functionless adenomas. Besides visual impairment, headache was a common symptom, but it seldom resulted in a medical consultation as did the symptoms related to hypopituitarism. It is concluded that through improved ophthalmological services these lesions can be detected at an earlier stage so that successful surgical treatment can then be obtained.

Key Words:

• pituitary adenoma
• visual dysfunction
• functionless adenoma
• immunohistological examination