Role of Endoscopic Skull Base and Keyhole Surgery for Pituitary and Parasellar Tumors Impacting Vision

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Title Role of Endoscopic Skull Base and Keyhole Surgery for Pituitary and Parasellar Tumors Impacting Vision
Creator Kelly, Daniel F; Griffiths, Chester F; Takasumi, Yuki; Rhee, John; Barkhoudarian, Garni; Krauss, Howard R
Affiliation Department of Neurology (CL, YS, JW, YH, QY, YJ, JZ), Beijing Tongren Hospital, Capital Medical University, Beijing, China; Departments of Ophthalmology and Neurology (VP), Indiana University, Indianapolis, Indiana; and Department of Radiology (HY), Beijing Tongren Hospital, Capital Medical University, Beijing, China
Subject Craniotomy; Humans; Laparoscopy; Pituitary Neoplasms; Skull Base; Skull Base Neoplasms; Vision Disorders
Abstract Optic perineuritis (OPN), an uncommon optic neuropathy, has previously not been described in patients with Behçet disease (BD). We conducted this study to describe the clinical features, response to treatment, and outcome of OPN due to BD, with particular emphasis on those features that might distinguish this from the idiopathic variety.; ; This is a retrospective, case series review of all patients with a diagnosis of OPN seen in a hospital-based neurology department from 2008 to 2014 who also met the international criteria for the diagnosis of BD.; ; Twenty-one patients with OPN were identified, of whom 10 (12 eyes) met the criteria for BD. OPN developed 2-10 years (mean, 4 years) after onset of BD, but the diagnosis of BD was made only after onset of OPN in 6. Nine of 12 eyes (75%) had severe visual loss (≤20/200), and 80% of patients progressed over several days from onset. After high-dose corticosteroid treatment, all patients experienced relief of pain, and 5 patients (50%) showed improved visual acuity. At last follow-up (mean, 25 months) 7 of 11 (64%) of affected eyes had good visual outcome (≥14/20), and no patient experienced a subsequent neurological event.; ; OPN may occur as a manifestation of BD and, in non-Western countries, this may be more common than the idiopathic variety. In contrast to idiopathic cases, OPN in BD is more likely to demonstrate initial rapid progression of visual loss and more severe loss at presentation. Patients show less recovery of vision in response to corticosteroids but carry a lower rate of subsequent relapse. Patients with OPN should be specifically questioned regarding symptoms of BD.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2015-12
Type Text
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s6gf4p04
Setname ehsl_novel_jno
Date Created 2017-09-14
Date Modified 2017-09-14
ID 1276418
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gf4p04
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