Humphrey visual field analysis, visual field defects, and ophthalmic findings in patients with macro pituitary adenoma

OBJECTIVE: To evaluate the Humphrey visual field parameters in patients with pituitary adenoma and classify the visual field defects in this patient group.

METHODS: Forty primary pituitary adenoma patients underwent neuro-ophthalmological examination and Humphrey Perimetry 30-2 visual field test at Baskent University, Departments of Ophthalmology, and Neurosurgery, between 2003 and 2005. Global indices, mean±SD and pattern standard deviation (PSD) of pituitary adenoma patients (group 1) were taken as the test parameters and compared with age- and sex- matched controls (group 2).

RESULTS: There were no significant differences between groups 1 and 2 with respect to mean age or gender distribution (p>0.05). The MD and PSD results of group 1 according to the age groups and gender were not statistically significant (p>0.05). The MD and PSD results of subjects in group 2 were within normal limits, and no special visual field defects were observed. When compared with healthy controls, the MD and PSD values of patients with hypophyseal adenomas were statistically significantly (p<0.05). In group 1, the mean adenoma size was 13.34 mm and no statistically significant correlation was found between the adenoma size and either the MD or PSD values (p>0.05). Sixteen (40%) patients had visual field defects, the specific complete bitemporal hemianopsia was found in 5 (12.5%) patients. Only in 3 patients (7.5%) the primary diagnosis was made by ophthalmologic examination.

CONCLUSION: Although ophthalmologists rarely have a role in the primary diagnosis of hypophyseal adenoma, routine ophthalmologic examination is still important. To detect early visual field abnormalities, automated perimetry should be performed as a part of routine examination in patients with suspected hypophyseal adenomas.