Predictive factors of visual function recovery after pituitary adenoma resection： a literature review and Meta-analysis  

作　　者：Min Sun Zhi-Qiang Zhang Chi-Yuan Ma Sui-Hua Chen Xin-Jian Chen 

机构地区：[1]School of Electronic and Information Engineering, Soochow University, Suzhou 215006, Jiangsu Province, China [2]Department of Electronic Engineering, Huaian College of Information Technology, Huaian 223003, Jiangsu Province, China [3]Department of Medical Imaging, Nanjing General Hospitalof Nanjing Military Command, Nanjing 210002, JiangsuProvince, China [4]Department of Neurosurgery, Nanjing General Hospitalof Nanjing Military Command, Nanjing 210002, JiangsuProvince, China [5]Department of Ophthalmology, Nanjing General Hospitalof Nanjing Military Command, Nanjing 210002, JiangsuProvince, China

出　　处：《International Journal of Ophthalmology(English edition)》2017年第11期1742-1750,共9页国际眼科杂志（英文版）

基　　金：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);the Natural Science Foundation of the Jiangsu Province (No.BK20140052)

摘　　要：AIM：To determine the dominant predictive factors of postoperative visual recovery for patients with pituitary adenoma.METHODS：Pub Med,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 January2000 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 Metaanalysis,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）.Predictivecharacteristics of four factors were revealed in this Metaanalysis 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（p RNFL）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 p RNFL thickness are the dominant predictive factors of the postoperative recovery of the visual field for patients with pituitary adenoma.AIM：To determine the dominant predictive factors of postoperative visual recovery for patients with pituitary adenoma.METHODS：Pub Med,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 January2000 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 Metaanalysis,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）.Predictivecharacteristics of four factors were revealed in this Metaanalysis 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（p RNFL）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 p RNFL thickness are the dominant predictive factors of the postoperative recovery of the visual field for patients with pituitary adenoma.

关 键 词：FIGURE 

分 类 号：R736.4[医药卫生—肿瘤]