The Impact of Age and Presentation with Vision Loss in Pituitary Adenomas: A Retrospective Analysis

In this single-center study, we aimed to determine if age at presentation was associated with vision loss and if this effect could be explained by tumor volume and/or cavernous sinus invasion. We conducted a retrospective chart review of patients surgically treated for a pituitary adenoma between 2017 and 2023 at an academic tertiary care center. A total of 123 patients were included in this study. Tumor volume was calculated using the traditional formula: (AP × CC × TR)/2, where AP, CC, and TR refer to the three dimensions of the tumor in centimeters. Visual loss was taken as a visual field deficit within 1 year prior to resection. 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 (r 2 = 0.02; p = 0.18). In addition, a critical age of 42.5 was determined to be when patients with pituitary adenomas begin to have a significantly increased likelihood of suffering from vision loss. Older patients with pituitary tumors were more likely to present with vision loss, but this was not associated with increased tumor volume or cavernous sinus invasion. Further research is needed to determine whether age-related thinning and increased vulnerability of the optic apparatus contribute to this finding.