垂体腺瘤视野表现的特征

Feature analysis of visual field defects in pituitary adenoma

目的探讨垂体腺瘤视野表现特征。方法收集于神经外科经病理确诊为垂体腺瘤的371例患者的视野及光学相干断层扫描(optical coherence tomography,OCT)资料。将垂体腺瘤患者根据视野缺损改变分为颞侧象限性视野缺损组、颞侧垂直性偏盲组和管状视野组。分析视野缺损形态特征,通过线性相关分析及方差分析对视野缺损形态、视野平均光敏感度(mean sensitivity,MS)等指标与OCT测量视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度、肿瘤体积之间的关系进行分析。结果颞侧象限性视野缺损组、颞侧垂直性偏盲组和管状视野组三组间RNFL厚度、MS值差异均具有统计学意义(均为P=0.00),垂体腺瘤体积差异无统计学意义(χ2=0.58,P=0.75)。颞侧垂直性偏盲组与管状视野组中,MS和对应眼鼻侧RNFL厚度有直线关系(R2=0.186,t=4.76,P=0.00;R2=0.146,t=2.65,P=0.01),RNFL厚度、MS与肿瘤体积均无直线关系(均为P>0.05)。结论视野缺损类型与垂体腺瘤侵犯视交叉的位置有关。相应受累眼视野缺损程度与视网膜RNFL厚度、MS值有一致性。受累眼的MS值变化与RNFL厚度有一致性。视野缺损改变、RNFL厚度、MS与肿瘤体积单一因素无关。

Objective To analyze visual field defects in pituitary adenoma. Methods A total of 371 patients with pituitary adenoma were enrolled in the nenro- surgery department, the features of visual field （VF） and OCT were collected. According to the VF defects patterns, patients were divided into 3 groups, temporal quadrant visual field defect group, temporal vertical visual field defect group and tubular visual field group. Linear correlation analysis and variance analysis were applied to figure out the relationship within the field defect morphology, average mean sensitivity （MS）, retinal nerve fiber layer （RNFL） thickness and pituitary adenoma volume. Results RNFL thickness and the mean MS among the temporal quadrant visual field defect group, tem- poral vertical visual field defect group and tubular visual field group had statistically sig- nificant difference （ all P = 0.00）, the difference of pituitary adenoma volume in the three groups was not statistically signiiicant（x2 = 0.58 ,P = 0.75 ）. In the temporal verti- cal visual field defect group and the tubular visual field group, average MS and the cor- responding eye＇ s nasal RNFL thickness had linear relationship （R2 = 0. 186, t = 4.75, P = 0.00 and R2 = 0. 145, t = 2.55,P = 0.01, respectively）, RNFL thickness and mean MS had no linear relationship with adenoma volume （ all P 〉 0.05 ）. Conclusion Variety of VF defect are related to the location of pituitary adenoma. The VF defect degree has agreement with the mean MS, RNFL. Mean MS of the damage eye has agreement with corresponding RNFL thickness. VF defect pattern, RNFL thickness and mean MS has no correlation with the isolate factor of average pituitary adenoma volume.