Cargando…
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...
Autores principales: | , , , , , , , |
---|---|
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 |
_version_ | 1784898892755632128 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9975539 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT jixiaoyu visualfieldimprovementafterendoscopictranssphenoidalsurgeryinpatientswithpituitaryadenoma AT zhuangxinyu visualfieldimprovementafterendoscopictranssphenoidalsurgeryinpatientswithpituitaryadenoma AT yangsiyuan visualfieldimprovementafterendoscopictranssphenoidalsurgeryinpatientswithpituitaryadenoma AT zhangkai visualfieldimprovementafterendoscopictranssphenoidalsurgeryinpatientswithpituitaryadenoma AT lixiaozhe visualfieldimprovementafterendoscopictranssphenoidalsurgeryinpatientswithpituitaryadenoma AT yuankun visualfieldimprovementafterendoscopictranssphenoidalsurgeryinpatientswithpituitaryadenoma AT zhangxiaofeng visualfieldimprovementafterendoscopictranssphenoidalsurgeryinpatientswithpituitaryadenoma AT sunxuebo visualfieldimprovementafterendoscopictranssphenoidalsurgeryinpatientswithpituitaryadenoma |