VISUAL-LOSS IN PREGNANT-WOMEN WITH PITUITARY-ADENOMAS

Objective: To investigate the potential risk for developing visual los s during single or multiple pregnancies in women with pituitary adenom as. Design: Cohort study. Setting: Referral center of a neuro-ophthalm ology service. Patients: 65 consecutive women with pituitary adenomas who had not been previously treated with surgery or radiation were mon itored during 111 pregnancies. Sixty had increased levels of serum pro lactin or growth hormone and 5 did not.Main Outcome Measures: Visual f ield or acuity loss was compared with the baseline size of the adenoma measured on the coronal view of the computed tomographic or magnetic resonance image. Results: Computed tomography or magnetic resonance im aging showed a definitive tumor (>0.3 cm, vertical height) in 57 patie nts, 8 of whom had macroadenomas (greater than or equal to 1.1 cm). Vi sual field loss occurred in 6 of 8 primiparous patients, all with aden omas greater than 1.1 cm (range, 1.2 to 2.5 cm). None of the 57 patien ts (95% CI, 0% to 6.3%) with a microadenoma or presumed microadenoma o f 1 cm or smaller developed visual loss-after as many as four full-ter m pregnancies. Conclusions: The risk for developing visual loss during single or multiple pregnancies in patients with microadenomas was sma ll. Six of eight pregnant women with macroadenomas, however, developed visual field loss during pregnancy.