AIM: To investigate the influencing factors of visual field improvement after trans-sphenoidal resection of pituitary macroadenomas. METHODS: This retrospective cohort study included 201 patients (366 eyes) with visua...AIM: To investigate the influencing factors of visual field improvement after trans-sphenoidal resection of pituitary macroadenomas. METHODS: This retrospective cohort study included 201 patients (366 eyes) with visual field defect induced by pituitary macroadenomas. All of them were treated with trans-sphenoidal surgery. Ophthalmologic evaluation, best -corrected visual acuity (BCVA), and visual field examination were performed before and 3mo after surgery. BCVA, visual field defect index mean deviation (MD), duration of symptoms, age, sex, and volume of tumors were compared. Expression of vascular endothelial growth factor (VEGF) and Ki-67 of tumor tissue were detected by immunohistochemical technique. RESULTS: The mean age of patients was 44.23 +/- 1.29y. Ninety -three patients were female and 108 were male. The mean tumor volume was 14.36 +/- 6.23 cm(3). The mean duration of preoperative symptoms was 11.50 +/- 0.88mo. Mean preoperative MD was -17.50 +/- 0.82 dB. Mean Preoperative visual acuity was 0.64 +/- 0.04. Postoperative visual field improved in 270 (73.77%) eyes, unchanged in 96 (26.23%) eyes. Multivariate logistic regression displayed that the factors independently influencing visual field improvement were young age (OR=1.71, 95%CI: 1.325-2.387, P=0.013), low preoperative MD absolute value (OR=1.277, 95%CI: 1.205-1.355, P<0.001), small volume of tumor (OR=1.458, 95%CI: 1.060-4.289, P<0.001), low expression of VEGF in tumor tissue (OR=1.554, 95%CI: 1.089-2.457, P=0.022), and low expression of Ki-67 in tumor tissue (OR=1.552, 95%CI: 1.161-2.847, P=0.026). CONCLUSION: After pituitary macroadenomas trans sphenoidal resection, the independent influencing factors of the visual fields recovery were low preoperative MD absolute value, young age, small volume of tumor, and expression levels of VEGF/Ki-67.展开更多
Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life...Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life and compliance. This study aimed to investigate the effects of sodium hyaluronate （SH） on ocular surface toxicity induced by BAC-preserved anti-glaucoma medications treatment. Methods： Filly-eight patients （101 eyes）, who received topical BAC-preserved anti-glaucoma medications treatment and met the severe dry eye criteria, were included in the analysis. All patients were maintained the original topical anti-glaucoma treatment. In the SH-treated group （56 eyes）, unpreserved 0.3% SH eye drops were administered with 3 times daily for 90 days. In the control group （55 eyes）, phosphate-butTered saline were administered with 3 times daily for 90 days. Ocular Surface Disease Index （OSDI） questionnaire, break-up time （BUT） test, corneal fluorescein staining, corneal and conjunctival rose Bengal staining, Schirmer test, and conjunctiva impression cytology were pertbrmed sequentially on days 0 and 91. Results： Compared with the control group, SH-treated group showed decrease in OSDI scores （Kruskal-Wallis test： H = 38.668, P 〈 0.001 ）, fluorescein and rose Bengal scores （Wilcoxon signed-ranks test： z = -3.843, P 〈 0.001, and z = 3.508, P 〈 0.001, respectively）, increase in tear fihn BUT （t-test： t - -10.994, P 〈 0.001 ） and aqueous tear production （t-test： t = -10.328, P 〈 0.001 ） on day 91. The goblet cell density was increased （t-test： t = -9.981, P 〈 0.001）, and the morphology of the conjunctival epithelium were also improved after SH treatment. Conclusions： SH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.展开更多
文摘AIM: To investigate the influencing factors of visual field improvement after trans-sphenoidal resection of pituitary macroadenomas. METHODS: This retrospective cohort study included 201 patients (366 eyes) with visual field defect induced by pituitary macroadenomas. All of them were treated with trans-sphenoidal surgery. Ophthalmologic evaluation, best -corrected visual acuity (BCVA), and visual field examination were performed before and 3mo after surgery. BCVA, visual field defect index mean deviation (MD), duration of symptoms, age, sex, and volume of tumors were compared. Expression of vascular endothelial growth factor (VEGF) and Ki-67 of tumor tissue were detected by immunohistochemical technique. RESULTS: The mean age of patients was 44.23 +/- 1.29y. Ninety -three patients were female and 108 were male. The mean tumor volume was 14.36 +/- 6.23 cm(3). The mean duration of preoperative symptoms was 11.50 +/- 0.88mo. Mean preoperative MD was -17.50 +/- 0.82 dB. Mean Preoperative visual acuity was 0.64 +/- 0.04. Postoperative visual field improved in 270 (73.77%) eyes, unchanged in 96 (26.23%) eyes. Multivariate logistic regression displayed that the factors independently influencing visual field improvement were young age (OR=1.71, 95%CI: 1.325-2.387, P=0.013), low preoperative MD absolute value (OR=1.277, 95%CI: 1.205-1.355, P<0.001), small volume of tumor (OR=1.458, 95%CI: 1.060-4.289, P<0.001), low expression of VEGF in tumor tissue (OR=1.554, 95%CI: 1.089-2.457, P=0.022), and low expression of Ki-67 in tumor tissue (OR=1.552, 95%CI: 1.161-2.847, P=0.026). CONCLUSION: After pituitary macroadenomas trans sphenoidal resection, the independent influencing factors of the visual fields recovery were low preoperative MD absolute value, young age, small volume of tumor, and expression levels of VEGF/Ki-67.
文摘Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life and compliance. This study aimed to investigate the effects of sodium hyaluronate （SH） on ocular surface toxicity induced by BAC-preserved anti-glaucoma medications treatment. Methods： Filly-eight patients （101 eyes）, who received topical BAC-preserved anti-glaucoma medications treatment and met the severe dry eye criteria, were included in the analysis. All patients were maintained the original topical anti-glaucoma treatment. In the SH-treated group （56 eyes）, unpreserved 0.3% SH eye drops were administered with 3 times daily for 90 days. In the control group （55 eyes）, phosphate-butTered saline were administered with 3 times daily for 90 days. Ocular Surface Disease Index （OSDI） questionnaire, break-up time （BUT） test, corneal fluorescein staining, corneal and conjunctival rose Bengal staining, Schirmer test, and conjunctiva impression cytology were pertbrmed sequentially on days 0 and 91. Results： Compared with the control group, SH-treated group showed decrease in OSDI scores （Kruskal-Wallis test： H = 38.668, P 〈 0.001 ）, fluorescein and rose Bengal scores （Wilcoxon signed-ranks test： z = -3.843, P 〈 0.001, and z = 3.508, P 〈 0.001, respectively）, increase in tear fihn BUT （t-test： t - -10.994, P 〈 0.001 ） and aqueous tear production （t-test： t = -10.328, P 〈 0.001 ） on day 91. The goblet cell density was increased （t-test： t = -9.981, P 〈 0.001）, and the morphology of the conjunctival epithelium were also improved after SH treatment. Conclusions： SH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.
