2025 Poster Presentations
P233: OLDER PATIENTS WITH PITUITARY ADENOMAS ARE MORE LIKELY TO PRESENT WITH VISION LOSS
Sayak R Ghosh, BS; Anne Lally, BS; Isabella L Pecorari, BS; Vijay Agarwal, MD; Montefiore Medical Center
Introduction: Pituitary adenomas are the most common intracranial neoplasm, and are most frequently benign. They vary greatly in their composition, as they can be functional and secrete hormones or they can be non-functional. Furthermore, any kind of tumor can cause symptoms of mass effect if large enough. One such symptom is visual impairment due to compression of the optic chiasm. Rates of visual impairment vary, and it is important to elucidate factors correlated with visual impairment. In addition, age at diagnosis for pituitary tumors vary greatly along with their presentation. Examining the relationship between age at diagnosis and visual impairment can allow us to characterize why certain patients do and do not present with vision loss.
Objective: In this single-center study, we aimed to determine if age at presentation was associated with rates of vision loss, and if this effect could be explained by tumor volume and cavernous sinus invasion.
Methods: We conducted a retrospective chart review of patients treated for pituitary adenoma between 2017 and 2023 at single academic tertiary care center. A total of 123 patients were included in this study. By race, 64 (52%) patients were Black, 14 (11%) patients were White, 2 (2%) were Asian, and 43 (35%) were other or declined to respond. By ethnicity, 39 (32%) patients were Hispanic/Latino, 71 (58%) were non-Hispanic/Latino, and 13 (11%) declined to respond. Vision loss was determined to be any presence of vision loss within one year prior to tumor resection. Tumor volume was calculated using the traditional formula: (AP x CC x TR)/2 , where AP, CC, and TR refer to the three dimensions of the tumor in centimeters. Cavernous sinus invasion was determined by pre-operative radiology reports.
Results: In our patient population, average age at presentation was 54.8 years. Our analysis showed that those with vision loss at presentation, were, on average, older than those who did not have vision loss at presentation (57.2 +/- 13.7 years [n=82] vs. 49.9 +/- 16.8 years [n=41]; p=0.02*). However, using simple linear regression, there was no correlation between age and tumor volume (r2 = 0.02; p = 0.18). Furthermore there was no difference in age between those who had cavernous sinus invasion and those who did not (55.4 +/- 17.8 years [n=57] vs 52.3 +/- 13.8 years [n=42]; p=0.32).
Conclusion: In our study, we found that those with pituitary tumors who presented with vision loss were older than those who did not. Prior studies show that vision loss can be associated with increased tumor volume. However, in our population, older patients who had increased rates of vision loss did not have increased tumor volume nor increased likelihood of cavernous sinus invasion. Further studies are needed to ascertain why older patients seemingly have higher rates of vision loss from pituitary tumors independent of their tumor volume, possibly related to age related thinning of and increased vulnerability of the optic apparatus.