Korean J Ophthalmol Vol.25, No.1, 2011 SITA standard strategy, we analyzed the pattern of VF de- fects and evaluated the correlation between the tumor vol- ume and severity of VF defects quantitatively in patients with pituitary macroadenoma. Materials and Methods We retrospectively reviewed the medical records of 50 pa- tients with pituitary macroadenoma who received VF tests in the Department of Ophthalmology and Neurosurgery, Hallym University Sacred Heart Hospital, between August 2000 and June 2008. Eleven patients were excluded because of unreliable VF test results (three patients) or other oph- thalmologic disease (eight patients). Our analysis was thus based on the remaining 39 cases. The diagnosis of pituitary macroadenoma was determined by the results of brain mag- netic resonance images (MRI). The patients underwent a complete ophthalmologic ex- amination including best-corrected visual acuity (BCVA), slit lamp biomicrosopy, applanation tonometry, fundus ex- amination and VF test. Patients with ophthalmologic disease or other disease affecting the results of VF test, whose BCVA results were lower than 20/80 in both eyes, and those with re- currence of tumor following previous treatment were excluded. A VF test was performed before surgery or medication for pituitary macroadenoma with a Humphrey field analyzer 750 2 (Zeiss-Humphrey, Dublin, CA, USA) using a 4 mm Goldmann size III stimulus. The 24-2 SITA standard strategy was used. Each patient underwent VF tests twice on separate days the more reliable result was selected for statistical analysis. The reliability criteria used were fixation losses less than 20%, as well as false positive and false negative errors less than 15%. VF examinations were considered abnormal if pattern standard deviation (PSD) or glaucoma hemifield test was abnormal. Based on either of the following criteria [13], quadranopsia was defined. 1) Depression of thresholds by 5 dB or more, in three or more contiguous points adjacent to the vertical meridian in the involved quadrant as compared to their mirror image points across the vertical meridian. 2) The pattern deviation plot showed three or more points adjacent to the vertical meridian in the involved quadrant de- pressed to the 1% probability level with normal mirror image points across the vertical meridian. For the diagnosis of hemianopsia, the diagnostic criteria for quadranopsia had to be applicable to both quadrants com- prising the hemifield. To quantify the severity of VF defects, we used results for the mean deviation (MD) and PSD of both eyes. The tumor volume was assessed radiologically on a brain MRI by the same neuroradiologist. For the estimation of tumor volume, it was assumed that pituitary tumors had an ellipsoid form [14]. Using Cavalieri’s principle, pituitary tu- mor volume was calculated after performing measurements of tumor diameter in three orthogonal planes, using the fol- lowing formula: tumor volume = 4/3π (a/2·b/2·c/2) (where 38 Table 1. Baseline characteristics of the patients with pituitary macroadenoma Variable No. of patients Male:Female Age (yr) Test time per eye (min) Mean deviation (dB) Pattern standard deviation (dB) Tumor volume (cm3) Values are means ± SD (range). Value 39 24:15 45.8 ± 15.6 (19-86) 5.87 ± 1.38 (4.5-8.75) -9.09 ± 6.85 (-23.47--0.02) 6.61 ± 4.15 (1.18-16.15) 8.71 ± 6.79 (1.02-33.20) Fig. 1. Humphrey visual field shows right incongruous homon- ymous hemianopia. Gadolinium-enhanced, T1-weighted magnetic resonance images of the brain reveal a mass that involves the optic tract. a,b, and c represent the diameters in the three dimensions). Statistical analysis was performed using SPSS ver. 12.0 (SPSS Inc., Chicago, IL, USA). To compare groups, a chi-square test used for categorical variables and Mann-Whitney U-test were used for continuous variables. Pearson’s correlation analysis was used to assess for relationships between tumor volume and MD and between tumor volume and PSD. All tests of association were considered statistically significant when p < 0.05. Results Among the 39 patients, 24 were male and 15 were female. The mean age was 45.8 ± 15.6 years, ranging from 19 to 86 years. The MD was -9.09 ± 6.85 dB and the PSD was 6.61 ± 4.15 dB. The baseline characteristics of the study partic- ipants are shown in Table 1. Types of VF defects in the patients are summarized in Table 2. Ten patients (26%) had normal VF and 29 patients (74%) had abnormal VF. Among the abnormal VF, seven pa- tients (18%) had unilateral VF defects, and 22 patients (56%) had bilateral VF defects. Most of bilateral VF defects were bitemporal hemianopsia. Interestingly there were three pa- tients with homonymous hemianopsia. These patients had a giant mass that involved the optic tract, one of which is shown in Fig. 1. A comparison between patients with and without VF de- fects linked to the pituitary macroadenoma is summarized in Table 3. There were no statistically significant differences in