Pituitary adenomas with ocular manifestations

Abstract

In the University Hospital of Lund, Sweden, 339 patients with pituitary adenomas and visual dysfunction were subjected to surgical treatment in 1946 through 1984. The mean annual incidence of treated cases increased from 4.07 per million inhabitants in 1946–55 to 6.93 in 1976–84, or by no less than 70%. The rise was most pronounced in the early 1960's but continued over the last years. Therefore, the treatment of an increasing number of small adenomas with isolated endocrine dysfunction did not result in any decrease of the number of large adenomas with visual dysfunction.

Three groups of cases were compared, namely those treated in 1946–60, in 1971–74, and in 1981–84, respectively. The mean duration of the visual impairment before treatment was shorter, and on the average, the visual function before and after treatment was better in patients treated after 1970 than before 1961.

The results were ascribed mainly to improved ophthalmological service after 1960. Modern endocrinological tools played a minor role, since the majority of the patients either lacked endocrine symptoms or suppressed them before they sought medical advice for visual complaints.

It seems unlikely that the role of the ophthalmologist will change very much in the future, which was suggested by some previous authors.

Key Words:

• pituitary adenoma
• visual acuity
• visual field defect
• optic nerve atrophy