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Visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma

PURPOSE: To analyze and predict the possibility of visual field (VF) recovery after endoscopic transsphenoidal surgery (ETSS) in patients with pituitary adenoma, we investigated the factors affecting the improvement of the visual field defect (VFD) and built a nomogram predictive model based on thes...

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Autores principales: Ji, Xiaoyu, Zhuang, Xinyu, Yang, Siyuan, Zhang, Kai, Li, Xiaozhe, Yuan, Kun, Zhang, Xiaofeng, Sun, Xuebo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975539/
https://www.ncbi.nlm.nih.gov/pubmed/36874088
http://dx.doi.org/10.3389/fonc.2023.1108883
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author Ji, Xiaoyu
Zhuang, Xinyu
Yang, Siyuan
Zhang, Kai
Li, Xiaozhe
Yuan, Kun
Zhang, Xiaofeng
Sun, Xuebo
author_facet Ji, Xiaoyu
Zhuang, Xinyu
Yang, Siyuan
Zhang, Kai
Li, Xiaozhe
Yuan, Kun
Zhang, Xiaofeng
Sun, Xuebo
author_sort Ji, Xiaoyu
collection PubMed
description PURPOSE: To analyze and predict the possibility of visual field (VF) recovery after endoscopic transsphenoidal surgery (ETSS) in patients with pituitary adenoma, we investigated the factors affecting the improvement of the visual field defect (VFD) and built a nomogram predictive model based on these risk factors. We further investigated specific recovery regions of VF associated with the improvement of VFD. METHODS: The clinical data of patients who underwent ETSS for pituitary adenomas at a single center between the January 2021 and April 2022 were retrospectively analyzed. Univariate and multivariate analyses were used to determine the predictive factors affecting the improvement in the VF defect and specific recovery regions in patients with pituitary adenomas after ETSS. RESULTS: We enrolled 28 patients (56 eyes) who were hospitalized at our institution. Four clinical features, including compression of the optic chiasm, preoperative mean defect (MD), diffuse defect, and duration of the visual symptom, were chosen from the least absolute shrinkage and selection operator regression analysis to establish the predictive nomogram. The nomogram’s area under the curve (AUC) was 0.912, indicating a good degree of differentiation. A calibration plot was used to evaluate the predictive model’s calibration, and a decision curve was used to evaluate its clinical application value. The VF defects were improved in the 270–300° range (270–300: RR = 361.00, 95% CI: 21.01–6,202.41). CONCLUSION: We developed a predictive nomogram model based on significant visual field improvement-associated factors after ETSS in patients with pituitary adenoma. Postoperative visual field improvement is likely to begin at 270–300° in the inferior temporal quadrant. This improvement would enable personalized counselling for individual patients by precisely predicting the visual field recovery after surgery.
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spelling pubmed-99755392023-03-02 Visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma Ji, Xiaoyu Zhuang, Xinyu Yang, Siyuan Zhang, Kai Li, Xiaozhe Yuan, Kun Zhang, Xiaofeng Sun, Xuebo Front Oncol Oncology PURPOSE: To analyze and predict the possibility of visual field (VF) recovery after endoscopic transsphenoidal surgery (ETSS) in patients with pituitary adenoma, we investigated the factors affecting the improvement of the visual field defect (VFD) and built a nomogram predictive model based on these risk factors. We further investigated specific recovery regions of VF associated with the improvement of VFD. METHODS: The clinical data of patients who underwent ETSS for pituitary adenomas at a single center between the January 2021 and April 2022 were retrospectively analyzed. Univariate and multivariate analyses were used to determine the predictive factors affecting the improvement in the VF defect and specific recovery regions in patients with pituitary adenomas after ETSS. RESULTS: We enrolled 28 patients (56 eyes) who were hospitalized at our institution. Four clinical features, including compression of the optic chiasm, preoperative mean defect (MD), diffuse defect, and duration of the visual symptom, were chosen from the least absolute shrinkage and selection operator regression analysis to establish the predictive nomogram. The nomogram’s area under the curve (AUC) was 0.912, indicating a good degree of differentiation. A calibration plot was used to evaluate the predictive model’s calibration, and a decision curve was used to evaluate its clinical application value. The VF defects were improved in the 270–300° range (270–300: RR = 361.00, 95% CI: 21.01–6,202.41). CONCLUSION: We developed a predictive nomogram model based on significant visual field improvement-associated factors after ETSS in patients with pituitary adenoma. Postoperative visual field improvement is likely to begin at 270–300° in the inferior temporal quadrant. This improvement would enable personalized counselling for individual patients by precisely predicting the visual field recovery after surgery. Frontiers Media S.A. 2023-02-15 /pmc/articles/PMC9975539/ /pubmed/36874088 http://dx.doi.org/10.3389/fonc.2023.1108883 Text en Copyright © 2023 Ji, Zhuang, Yang, Zhang, Li, Yuan, Zhang and Sun https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Ji, Xiaoyu
Zhuang, Xinyu
Yang, Siyuan
Zhang, Kai
Li, Xiaozhe
Yuan, Kun
Zhang, Xiaofeng
Sun, Xuebo
Visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma
title Visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma
title_full Visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma
title_fullStr Visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma
title_full_unstemmed Visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma
title_short Visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma
title_sort visual field improvement after endoscopic transsphenoidal surgery in patients with pituitary adenoma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975539/
https://www.ncbi.nlm.nih.gov/pubmed/36874088
http://dx.doi.org/10.3389/fonc.2023.1108883
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