Walsh & Hoyt: Visual Prognosis in Patients with Pituitary Adenomas

The prognosis for return of visual function in patients whose tumors have caused loss of visual acuity, visual field, or both depends on the duration of symptoms, severity of visual loss, presence or absence of optic atrophy, age of the patient, and size of the tumor. The pattern of recovery of visual function after decompression of the anterior visual pathways suggests at least three phases of improvement. The early fast phase (surgery to 1 week) of improvement may lead to normalization of visual fields in some individuals. The early slow phase (14 months) is the period of most notable improvement. A late phase (6 months to 3 years) of mild improvement does not appear significant overall but may be marked in some individuals. Each of these phases may have one or more mechanisms underlying the observed improvement.