pISSN: 1011-8942 eISSN: 2092-9382 Korean J Ophthalmol 2011;25(1):37-41 DOI: 10.3341/kjo.2011.25.1.37 Original Article The Volume of Tumor Mass and Visual Field Defect in Patients with Pituitary Macroadenoma Jung Pil Lee, In Won Park, Yun Suk Chung Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea Purpose: We used the Swedish interactive threshold algorithms (SITA) standard strategy of Humphrey perimetry, to analyze the pattern of visual field (VF) defects and evaluate the quantitative correlation between the tumor vol- ume and severity of VF defects in patients with pituitary macroadenoma. Methods: We reviewed 50 patients with pituitary macroadenoma who received VF test and 11 patients were excluded. VF analysis was performed with Humphrey perimeter using the SITA standard strategy. The tumor vol- ume was assessed radiologically via brain magnetic resonance images and was calculated using Cavalieri’s principle. We used the mean deviation (MD) and pattern standard deviation (PSD) of the Humphrey parameter to measure VF defect severity, and then analyzed the correlation of tumor volume with VF defects. Results: Twenty nine patients (74%) showed abnormal VF and bitemporal field changes, which were the most com- mon field defects on presentation. Seven patients (18%) had unilateral VF defects, 22 patients (56%) had bi- lateral VF defects. The tumor volume of the patients with VF defects was significantly larger than that of patients with normal VF (p = 0.006). The tumor volume exhibited significant negative correlation with MD (r = -0.693; p < 0.001) and significant positive correlation with PSD (r = 0.589; p < 0.001). Conclusions: In patients with pituitary macroadenoma, there was a variety of VF defects and a high correlation be- tween the tumor volume and the severity of VF defects. SITA standard strategy can be a fast and quantitative method for evaluating central VF defects. Key Words: Mean deviation, Pattern standard deviation, Pituitary macroadenoma, Swedish interactive threshold algorithms standard strategy, Visual field defects Pituitary adenomas account for approximately 12% of clinically symptomatic intracranial tumors [1]. They are classified into two categories based on their size, micro- adenoma (less than 1 cm) and macroadenoma (greater than 1 cm) [2]. Pituitary macroadenoma can cause visual field (VF) defects by compressing the optic chiasm or the optic nerve. The prevalence of VF defects in pituitary adenoma varies, ranging from 9% to 32% as reported in the literature [1,3,4]. Because of its anatomical relationship with the optic chiasm, pituitary adenoma typically results in bitemporal hemianopia. Received: May 24, 2010 Accepted: September 5, 2010 Corresponding Author: Yun Suk Chung, MD. Department of Ophthalmology, Hallym University Sacred Heart Hospital, #896 Pyeongchon-dong, Dongan-gu, Anyang 431-070, Korea. Tel: 82-31-380-3835, Fax:82-31- 380-3837, E-mail: eyechung90@hallym.or.kr * This article was presented in part at the 100th autumn meeting of Korean Ophthalmological Society, October 2008, Goyang, Korea. However, according to tumor size and optic chiasmal posi- tion, a variety of field defects can be produced by pituitary adenoma and the tumor size is a significant factor for the se- verity of VF defects [5,6]. Goldmann perimetry has been classically considered to be the standard perimetry technique in neuro-ophthalmology. However, several studies reported that most automated peri- metry was similar or more sensitive than Goldmann perimetry in detecting and quantifying VF defects in neuro-ophthalmol- ogy [7-9]. Recent studies have the Humphrey’s full-threshold strategy, however it requires a higher level of understanding and greater concentration by the patient [10,11]. The Swedish interactive threshold algorithms (SITA) family of automated perimetry is the most recently developed and most widely used program resulting in a much shorter VF testing process that is easier for the patient [12]. To the best of our knowledge, there has been no study spe- cifically designed to evaluate the results of SITA strategy in patients with pituitary adenoma. Using the Humphrey’s ⓒ 2011 The Korean Ophthalmological Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses /by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 37