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Correction to: Quality of care evaluation in non-functioning pituitary adenoma with chiasm compression: visual outcomes and timing of intervention clinical recommendations based on a systematic literature review and cohort study
- Source :
- Pituitary
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Surgery in patients with non-functioning pituitary macroadenomas (NFMA) is effective in ameliorating visual function. The urgency for decompression, and preferred timing of surgery related to the preoperative severity of dysfunction is unknown.Systematic review for evidence to provide clinical guidance for timing of surgical decompression of the optic chiasm, and a cohort study of 30 NFMA patients, in whom mean deviation (MD), and severity of visual dysfunction was assessed.Systematic review 44 studies were included with a total of 4789 patients. Postoperatively, visual field defects improved in 87.0% of patients, stabilized in 12.8% and worsened in 1.0%. Specific protocols regarding timing of surgery were not reported. Only seven studies (16.7%) reported on either the duration of visual symptoms, or diagnostic, or treatment delay. Cohort study 30 NFMA patients (50% female, 60 eyes, mean age 58.5 ± 14.8 years), had a median MD of - 5.3 decibel (IQR - 3.1 to - 10.1). MD was strongly correlated with clinical severity (r = - 0.94, P 0.0001), and were used for severity of defects cut-off values: (1) normal - 2 dB, (2) mild - 2 dB to - 4 dB, (3) moderate - 4 to - 8 dB, (4) severe - 8 to - 17 dB, (5) very severe - 17 dB.Surgical decompression is highly effective in improving visual function. Uniform, quantitative grading of visual dysfunction was lacking. MD is a promising quantitative outcome measure. We provide recommendations for the evaluation of timing of surgery, considering severity of visual impairment, which will need further validation based on expert clinical practice.
- Subjects :
- Adenoma
Male
Pediatrics
medicine.medical_specialty
Time Factors
Endocrinology, Diabetes and Metabolism
Functioning Pituitary Adenoma
Vision Disorders
Visual Acuity
030209 endocrinology & metabolism
Severity of Illness Index
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Endocrinology
Intervention (counseling)
Humans
Medicine
Pituitary Neoplasms
Quality of care
Quality of Health Care
business.industry
Correction
Recovery of Function
Middle Aged
Decompression, Surgical
Tumor Burden
Term (time)
Treatment Outcome
Systematic review
Optic Chiasm
Hemianopsia
Visual Field Tests
Female
business
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 15737403 and 1386341X
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Pituitary
- Accession number :
- edsair.doi.dedup.....80f220cf84730d963158dd84b1a1f01f
- Full Text :
- https://doi.org/10.1007/s11102-020-01061-z