视野缺损对蝶鞍区肿瘤诊断及治疗的意义

The significance of perimetry in diagnosis and therapeutic assessment of sellar tumor

目的:探讨视野缺损对蝶鞍区肿瘤诊断及治疗的意义。方法:对22例(44只眼)蝶鞍区肿瘤患者的视野检查结果,其中包括眼科门诊患者8例(16只眼)、住院患者14例(28只眼),进行回顾性分析。结果:蝶鞍区肿瘤以垂体瘤居多(81.8%)。在首发症状中视力下降占大多数,为77.3%,并可伴有头痛或者其他症状如内分泌异常等。眼底检查视盘苍白者占多数(81.8%)。视野改变以垂直性偏盲为主要表现,其中典型的表现为双眼或单眼颞侧偏盲。常用手术治疗方式为经额颞幕上开颅手术及经蝶骨入路手术,术后视力、视野均有不同程度恢复。结论:蝶鞍区肿瘤中垂体瘤占大多数。视野改变可表现为垂直性偏盲、不规则视野缺损、视野向心性缩小等。

objective To discuss the significanace of perimetry in diagnosis and therapeutic assessment of sellar tumor. Method 22 patients (44 eyes) who had suffered from sellar tumors and treated in No.2 hospital of Jilin university were retrospectively reviewed. Among them, 8 patients (16 eyes) were outpatients of ophthalmic department, and 14 patients (28 eyes) came from department of neurosurgery. Results Among sellar tumors, pituitary adenomas are more common than other typal tumors (81.8%). Blurred vision could be detected firstly by patients (77.3%) sometimes. There may have other symptoms, such as headache or some abnormal endocrine symptoms simultaneously. pale optic disc often could be found by ophthalmoscopy (81.8%). The most common type of visual field defects is vertical hemianopsia, and bilateral temporal hemianopsia and unilateral hemianopsia. Surgery can be performed by the transcranial approach or by the transsphenoidal approach usually, and visual acuities and visual fields restored in some degree after operation. Conclusion Pituitary adenomas occupy a large percent in tumors of sellar region. visual field defects can be vertical hemianopsia, irregular defects or endocentric constriction of visual fields etc in clinic.