AIM:Toinvestigatetheinfluencingfactorsofvisualfieldimprovementaftertrans-sphenoidalresectionofpituitarymacroadenomas.·METHODS:Thisretrospectivecohortstudyincluded201patients(366eyes)withvisualfielddefectinducedbypituitarymacroadenomas.Allofthemweretreatedwithtrans-sphenoidalsurgery.Ophthalmologicevaluation,best-correctedvisualacuity(BCVA),andvisualfieldexaminationwereperformedbeforeand3moaftersurgery.BCVA,visualfielddefectindexmeandeviation(MD),durationofsymptoms,age,sex,andvolumeoftumorswerecompared.Expressionofvascularendothelialgrowthfactor(VEGF)andKi-67oftumortissueweredetectedbyimmunohistochemicaltechnique.·RESULTS:Themeanageofpatientswas44.23±1.29y.Ninety-threepatientswerefemaleand108weremale.Themeantumorvolumewas14.36±6.23cm~3.Themeandurationofpreoperativesymptomswas11.50±0.88mo.MeanpreoperativeMDwas-17.50±0.82dB.MeanPreoperativevisualacuitywas0.64±0.04.Postoperativevisualfieldimprovedin270(73.77%)eyes,unchangedin96(26.23%)eyes.Multivariatelogisticregressiondisplayedthatthefactorsindependentlyinfluencingvisualfieldimprovementwereyoungage(OR=1.71,95%CI:1.325-2.387,P=0.013),lowpreoperativeMDabsolutevalue(OR=1.277,95%CI:1.205-1.355,P<0.001),smallvolumeoftumor(OR=1.458,95%CI:1.060-4.289,P<0.001),lowexpressionofVEGFintumortissue(OR=1.554,95%CI:1.089-2.457,P=0.022),andlowexpressionofKi-67intumortissue(OR=1.552,95%CI:1.161-2.847,P=0.026).·CONCLUSION:Afterpituitarymacroadenomastranssphenoidalresection,theindependentinfluencingfactorsofthevisualfieldsrecoverywerelowpreoperativeMDabsolutevalue,youngage,smallvolumeoftumor,andexpressionlevelsofVEGF/Ki-67.
