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Pituitary

, Volume 22, Issue 4, pp 405–410 | Cite as

Increased frequency of cataract surgery in patients over age 50 with pituitary macroadenomas and chiasmal compression

  • Mina M. Gerges
  • Mohamed M. Arnaout
  • Abad Cherif El Asri
  • Matthew D. Cummock
  • Ahmed Roshdy
  • Vijay K. Anand
  • Marc J. Dinkin
  • Cristiano Oliveira
  • Theodore H. SchwartzEmail author
Article
  • 59 Downloads

Abstract

Background

Patients with visual loss from macroadenomas compressing their optic apparatus may also have concomitant age-related visual pathology such as cataracts. How these two pathologies interact with each other is not well documented.

Objective

The interaction between these two pathologies in elderly patients is the subject of this study.

Methods

We identified a series of non-functioning macroadenoma patients over age 50 years with tumors compressing the chiasm who underwent transsphenoidal surgery at our institution between 2004 and 2018. Pre- and post-operative visual complaints, tumor size and extent of resection were analyzed. Prevalence of the diagnosis of cataract and prevalence of cataract surgery in each decade were compared with national averages.

Results

We identified 200 patients who met selection criteria. 18% of these patients had a diagnosis of cataract and 12.5% had cataract surgery. Compared with the Eye Diseases Prevalence Research Group (EDPRG) study, the prevalence of cataract surgery was 2.5 times the national average of 5.1%. 32% of these patients had no improvement in their vision after cataract surgery but 76% improved after transsphenoidal surgery.

Conclusions

We reported a high prevalence of cataract surgery in patients over age 50 in patients with pituitary macroadenomas compressing the optic pathway compared with national averages in patients without adenomas. While visual loss from adenoma likely precipitated more cataract surgeries in this group of patients, some who may not have required it, those patients with cataracts who did not have their cataracts extracted were less likely to recover vision after transsphenoidal surgery. Addressing both pathologies is beneficial.

Keywords

Chiasma Cataract Cataract Surgery Prevalence Vision Elderly Macroadenoma Pituitary Adenoma Transsphenoidal Surgery Endoscopic 

Notes

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

References

  1. 1.
    World Health Organization (2015) World report on ageing and health. World Health Organization, GenevaGoogle Scholar
  2. 2.
    Attebo K, Mitchell P, Smith W (1996) Visual acuity and the causes of visual loss in Australia: the Blue Mountains Eye Study. Ophthalmology 103(3):357–364CrossRefGoogle Scholar
  3. 3.
    Mitchell P, Cumming RG, Attebo K, Panchapakesan J (1997) Prevalence of cataract in Australia: the Blue Mountains eye study. Ophthalmology 104(4):581–588CrossRefGoogle Scholar
  4. 4.
    Kanthan GL, Wang JJ, Rochtchina E, Tan AG, Lee A, Chia E-M, Mitchell P (2008) Ten-year incidence of age-related cataract and cataract surgery in an older Australian population: the Blue Mountains Eye Study. Ophthalmology 115(5):808–814.  https://doi.org/10.1016/j.ophtha.2007.07.008 CrossRefGoogle Scholar
  5. 5.
    Keeffe JE, Taylor HR (1996) Cataract surgery in Australia 1985–94. Aust N Zeal J Ophthalmol 24(4):313–317CrossRefGoogle Scholar
  6. 6.
    Ostrom QT, Gittleman H, Farah P, Ondracek A, Chen Y, Wolinsky Y, Stroup NE, Kruchko C, Barnholtz-Sloan JSJN (2013) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in the United States in 2006-2010. Neuro-oncol 15(Suppl_2):ii1–ii56Google Scholar
  7. 7.
    Ezzat S, Asa SL, Couldwell WT, Barr CE, Dodge WE, Vance ML, McCutcheon IE (2004) The prevalence of pituitary adenomas: a systematic review. Cancer 101(3):613–619.  https://doi.org/10.1002/cncr.20412 CrossRefGoogle Scholar
  8. 8.
    Barrow DL, Tindall GTJN (1990) Loss of vision after transsphenoidal surgery. Neurosurgery 27(1):60–68CrossRefGoogle Scholar
  9. 9.
    Memel Z, Chesney K, Pangal DJ, Bonney PA, Carmichael JD, Zada G (2018) Outcomes following transsphenoidal pituitary surgery in the elderly: a retrospective single-center review. Op Neurosurg.  https://doi.org/10.1093/ons/opy109 Google Scholar
  10. 10.
    Wilson PJ, Omay SB, Kacker A, Anand VK, Schwartz THJJ (2018) Endonasal endoscopic pituitary surgery in the elderly. J Neurosurg 128(2):429–436CrossRefGoogle Scholar
  11. 11.
    Esquenazi Y, Essayed WI, Singh H, Mauer E, Ahmed M, Christos PJ, Schwartz TH (2017) Endoscopic endonasal versus microscopic transsphenoidal surgery for recurrent and/or residual pituitary adenomas. World Neurosurg 101:186–195.  https://doi.org/10.1016/j.wneu.2017.01.110 CrossRefGoogle Scholar
  12. 12.
    Chohan MO, Levin AM, Singh R, Zhou Z, Green CL, Kazam JJ, Tsiouris AJ, Anand VK, Schwartz TH (2016) Three-dimensional volumetric measurements in defining endoscope-guided giant adenoma surgery outcomes. Pituitary 19(3):311–321.  https://doi.org/10.1007/s11102-016-0709-2 CrossRefGoogle Scholar
  13. 13.
    Negm HM, Al-Mahfoudh R, Pai M, Singh H, Cohen S, Dhandapani S, Anand VK, Schwartz TH (2017) Reoperative endoscopic endonasal surgery for residual or recurrent pituitary adenomas. J Neurosurg 127(2):397–408.  https://doi.org/10.3171/2016.8.JNS152709 CrossRefGoogle Scholar
  14. 14.
    Alahmadi H, Vachhrajani S, Cusimano MD (2010) The natural history of brain contusion: an analysis of radiological and clinical progression. J Neurosurg 112(5):1139–1145.  https://doi.org/10.3171/2009.5.JNS081369 CrossRefGoogle Scholar
  15. 15.
    Kothari RU, Brott T, Broderick JP, Barsan WG, Sauerbeck LR, Zuccarello M, Khoury J (1996) The ABCs of measuring intracerebral hemorrhage volumes. Stroke 27(8):1304–1305CrossRefGoogle Scholar
  16. 16.
    Congdon N, Vingerling JR, Klein BEK, West S, Friedman DS, Kempen J, O’Colmain B, Wu Y, Taylor HR, Wang JJ, Grp EDPR (2004) Prevalence of cataract and pseudophakia/aphakia among adults in the United States. Arch Ophthalmol 122(4):487–494CrossRefGoogle Scholar
  17. 17.
    Luomaranta T, Raappana A, Saarela V, Liinamaa MJ (2017) Factors affecting the visual outcome of pituitary adenoma patients treated with endoscopic transsphenoidal surgery. World Neurosurg 105:422–431.  https://doi.org/10.1016/j.wneu.2017.05.144 CrossRefGoogle Scholar
  18. 18.
    Hajiabadi M, Alimohamadi M, Fahlbusch RJW (2015) Decision making for patients with concomitant pituitary macroadenoma and ophthalmologic comorbidity: a clinical controversy. World Neurosurg 84(1):147–153CrossRefGoogle Scholar
  19. 19.
    Phu J, Khuu SK, Yapp M, Assaad N, Hennessy MP, Kalloniatis MJC (2017) Optometry E: the value of visual field testing in the era of advanced imaging: clinical and psychophysical perspectives. 100(4):313–332Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Mina M. Gerges
    • 1
    • 2
  • Mohamed M. Arnaout
    • 2
    • 5
  • Abad Cherif El Asri
    • 2
    • 7
  • Matthew D. Cummock
    • 2
    • 6
  • Ahmed Roshdy
    • 1
  • Vijay K. Anand
    • 3
  • Marc J. Dinkin
    • 8
  • Cristiano Oliveira
    • 8
  • Theodore H. Schwartz
    • 2
    • 3
    • 4
    Email author
  1. 1.Department of Neurosurgery, Faculty of MedicineAin Shams UniversityCairoEgypt
  2. 2.Department of Neurological Surgery, Weill Cornell MedicineNewYork-Presbyterian HospitalNew YorkUSA
  3. 3.Department of Otolaryngology, Weill Cornell MedicineNewYork-Presbyterian HospitalNew YorkUSA
  4. 4.Department of Neuroscience, Weill Cornell MedicineNewYork-Presbyterian HospitalNew YorkUSA
  5. 5.Department of Neurosurgery, Faculty of MedicineZagazig UniversitySharqiaEgypt
  6. 6.Department of Neurological SurgerySt. Barnabas Medical CenterLivingstonUSA
  7. 7.Department of Neurological SurgeryMilitary hospital Mohamed VRabatMorocco
  8. 8.Department of Ophthalmology, Weill Cornell MedicineNewYork-Presbyteian HospitalNew YorkUSA

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