Preoperative somatostatin analogues improve visual function in acromegaly patients

Abstract

Abstract Purpose: Our study was to evaluate the effect of preoperative somatostatin analogues(SSA) on acromegaly patients with visual dysfunction. Methods: An analysis of 31 eyes of 17 acromegaly patients with visual dysfunction was retrospectively conducted, the best corrected visual acuity and visual field (VF) were mainly evaluated. Pared-samples T test and Wilcoxon signed rank test were used to compare the quantitative analysis of VF standard automated perimetry (SAP) mean deviation (MD) values and pattern standard deviation values (PSD) before and after the treatment of SSA. What’s more, the growth hormone (GH), Insulin-Like Growth Factor 1(IGF1) and tumor size of the 17 patients were also analyzed retrospectively. Results: In total, sixteen patients (94%) presented with tumors of high Knosp grade, the median preoperative treatment duration of SSA was 3 months. The average MD of visual field parameter in SSA treatment was significantly increased (-7.33 vs. -5.45 dB, P＜0.001), the median PSD of visual field parameter in SSA treatment was significantly decreased (6.50 vs. 2.98 dB; P＝0.003). The median GH fell from 41.43 ng/ml to 17.6 ng/ml (P＝0.015), the IGF1 decreased from an average of 812.2 ng/ml to 647.36 ng/ml (P＝0.010). The tumor size including tumor volumes, maximum diameter, maximum vertical diameter also decreased significantly. Conclusion: This study has demonstrated beneficial effect of preoperative SSA on visual function in acromegaly patients with high Knosp grade, which provided evidence of the preoperative SSA medication on visual function protection, biochemical control, and tumor size reduction.