Citation:Sun M,Zhang ZQ,Ma CY,Chen SH,Chen XJ.Predictive factors of visual function recovery after pituitary adenoma resection: a literature review and Meta-analysis.Int J Ophthalmol 2017;10(11):1742-1750,doi:10.18240/ijo.2017.11.17
Predictive factors of visual function recovery after pituitary adenoma resection: a literature review and Meta-analysis
Received:August 30, 2016  Revised:July 11, 2017
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DOI:10.18240/ijo.2017.11.17
Key Words:pituitary adenoma  visual function recovery prediction  retinal thickness  visual field defect
Fund Project:Supported in part by the National Basic Research Program of China (973 Program) (No.2014CB748600); the National Natural Science Foundation of China (No.81371629; No.81401472; No.61401293; No.61401294; No.61622114); and the Natural Science Foundation of the Jiangsu Province (No.BK20140052).
              
AuthorInstitution
Min Sun School of Electronic and Information Engineering, Soochow University, Suzhou , Jiangsu Province, China; Department of Electronic Engineering, Huaian College of Information Technology, Huaian , Jiangsu Province, China
Zhi-Qiang Zhang Department of Medical Imaging, Nanjing General Hospital of Nanjing Military Command, Nanjing , Jiangsu Province, China
Chi-Yuan Ma Department of Neurosurgery, Nanjing General Hospital of Nanjing Military Command, Nanjing , Jiangsu Province, China
Sui-Hua Chen Department of Ophthalmology, Nanjing General Hospital of Nanjing Military Command, Nanjing , Jiangsu Province, China
Xin-Jian Chen School of Electronic and Information Engineering, Soochow University, Suzhou , Jiangsu Province, China
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Abstract:
      AIM: To determine the dominant predictive factors of postoperative visual recovery for patients with pituitary adenoma.

    METHODS: PubMed, Google Scholar, Web of Science and Cochrane Library were searched for relevant human studies, which investigated the prediction of the postoperative visual recovery of patients with pituitary adenoma, from January 2000 to May 2017. Meta-analyses were performed on the primary outcomes. After the related data were extracted by two independent investigators, pooled weighted mean difference (WMD) and odds ratio (OR) with 95% confidence interval (CI) were estimated using a random-effects or a fixed-effects model.

    RESULTS: Nineteen studies were included in the literature review, and nine trials were included in the Meta-analysis, which comprised 530 patients (975 eyes) with pituitary adenoma. For the primary outcomes, there was a significant difference between preoperative and postoperative mean deviation (MD) values of the visual field (WMD -5.85; 95%CI: -8.19 to -3.51; P<0.00001). Predictive characteristics of four factors were revealed in this Meta-analysis by assigning the patients to sufficient and insufficient groups according to postoperative visual field improvements, including preoperative visual field defect (WMD 10.09; 95%CI: 6.17 to 14.02; P<0.00001), patient age (WMD -12.32; 95%CI: -18.42 to -6.22; P<0.0001), symptom duration (WMD -5.04; 95%CI: -9.71 to -0.37; P=0.03), and preoperative peripapillary retinal nerve fiber layer (pRNFL) thickness (OR 0.1; 95% CI: 0.04 to 0.23; P<0.00001).

    CONCLUSION: Preoperative visual field defect, symptom duration, patient age, and preoperative pRNFL thickness are the dominant predictive factors of the postoperative recovery of the visual field for patients with pituitary adenoma.

PMC FullText Html:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686375/
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