Iftikhar Ali Raja, Iftikhar Ali Raja, Anjum Habib, Rizwan Masood Butt.
Visual Prognosis in Tumours of Sella and Parasellar Areas.
Pak J Ophthalmol Jan ;12(3):79-84.

The object of this retrospective study was to analyze the visual prognosis in patients with tumours in and around the sellar area. From January 1977 to December 1994 i.e. over a period of 18 years, 206 patients were studied. There were 128 patients with pituitary adenomas, 56 with craniopharyngiomas, 20 with suprasellar meningiomas and 2 with pituitary fossa tuberculomas. According to the visual fields, the patients were divided into four groups. The average time of presentation was 1 112 years. All patients were operated on through transcranial approach. Follow-up period varied from 3 months to 12 years. In the postoperative follow-up, amongst 39 patients of group I, 27 had complete visual recovery, 9 had partial recovery and 3 did not show any improvement. Amongst 22 patients of group II 13 had complete recovery, 5 had partial recovery and 4 did not show any visual improvement. In 60 patients of group III, 4 had partial visual improvement while 56 did not show any improvement and in 80 patients of group-IV, no improvement in vision was noticed postoperatively. There were 2 fatalities in group III and 3 in group IV. Eighty patients out of group 111 and IV started complaining of visual deterioration within three months of operation. The CT Scan of the brain was repeated at 3 months, 6 months and thereafter yearly. Of these, 23 patients had recurrence of tumour and were re-operated. Of the remaining 57 patients, no recurrence was detectable on brain CT at the end of 2 years. Forty-two patients had postoperative radiation. Inspite of no tumour recurrence, the vision in these 57 patients went on deteriorating. We believe that gross optic atrophic changes were responsible for their ultimate blindness inspite of decompression of the visual pathways. Postoperative radiation probably adds to the visual deterioration.

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