Management-specific outcome evaluation of pituitary apoplexy; conservative and surgical approach
Authors' conclusion
The choice for surgery is mainly driven by ophthalmological symptoms, in which severity determines its timing. Although ophthalmological recovery rates are reasonable, (endocrine) outcomes of apoplexy are unfavorable, irrespective of trajectory. Prospective studies are needed to assess optimal (timing of) treatment, in particular in those patients without an obvious reason for early surgery, taking into account the heterogeneity and variable course of this condition.
Study context
- Population
- Patients with clinical pituitary apoplexy diagnosed 2005–2021 at a pituitary center of excellence
- Participants
- 98 patients
- Exposure
- Early surgery vs initial conservative management
- Early surgeryn = 45
- Conservative managementn = 53reference
- Outcome
- Visual outcomes after surgery
Main finding
As reported in the abstract
Early surgery: mean visual acuity (VA) postoperatively vs before (SD)
from 0.63 (SD = 0.36) to 1.03 (SD = 0.3)
Early surgery: Visual field defects (VFD) improved
72.2%
Initially conservative, later elective surgery: n
21
Later elective surgery: VFD improved
85.7%
Observational data: associations, not effects.
Further findings
Indications for early surgery
- Main indications for early surgery were lowered VA and/or severe VFD
Follow-up
- Mean follow-up for each group
- > 38 months
Original publication
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