39例垂体瘤视野的改变规律

The characteristics of visual field loss in 39 patients with pituitary adenoma

目的分析垂体瘤患者视野改变的特点。方法将39例垂体瘤患者的术前视野结果其分为正常、轻度受损、中度受损、重度受损4种基本类型,总结这4种类型的基本视野特点并由此总结视野缺损的发展变化过程。结果 2只眼视野正常,34只眼出现局部视敏度的降低和不多的暗点,24只眼出现两个象限的视野缺损,18只眼出现3个象限及以上的缺损,视野缺损程度存在很大差异.结论根据这些视野改变,垂体瘤患者视野缺损遵循颞上象限-颞下象限-鼻上象限-整个视野范围受损害的进展规律,但是又因每个人的鞍区结构及病理情况的差异有所不同。

Objective To study the characters of visual field impairment in patients with pituitary adenoma. Methods Visual fields were measured in 39 patients by using Goldmann perimetry. The visual field impairment was divid- eel into one of four types according to its severity ： normal, mild, medium and severe. Results Two eyes showed normal visual fields. Thirty-four eyes exhibited decreased sensitivity and a few seotomas within visual fields. Twenty-four eyes had defects in two quadrants. Eighteen eyes had defects in more than three quadrants. Conclustion From these results, we concluded that visual defect usually evolves from superior-temporal quadrant to inferior-temporal quadrant, then to superior- nasal quadrant, and finally to the whole field. However,due to the diversity of sellar area pathology, the characters of visual field defects in patients with pituitary adenoma could be very individualized.