Visual outcome in patients with macroprolactinoma treated with dopamine agonists

• Published in: Revista medíca de Chile Vol. 141; no. 6; pp. 687 - 694
• Main Authors: Cuevas, José Luis, Fernández, Verónica, Rojas, David, Wohllk, Nelson, González, Oscar, Torche, Esteban
• Format: Journal Article
• Language: Spanish
• Published: Chile 01-06-2013
• Subjects: Adolescent; Adult; Bromocriptine - therapeutic use; Child; Dopamine Agonists - therapeutic use; Ergolines - therapeutic use; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Prolactinoma - complications; Prolactinoma - surgery; Retrospective Studies; Vision Disorders - drug therapy; Vision Disorders - etiology; Visual Acuity; Visual Fields; Young Adult
• ISSN: 0717-6163
• DOI: 10.4067/S0034-98872013000600001

Dopamine agonists (DA) effectively reduce tumor size of macroprolactinomas, with the consequent improvement of eventual visual impairment.
To study the visual outcomes in patients with macroprolactinoma treated with DA.
Retrospective cohort study which included patients with macroprolactinoma controlled at a Neuro-endocrinology and Neuro-ophthalmology Department between 1997 and 2011, and treated exclusively with DA (bromocriptine or cabergoline). Patients who were operated or had previous radiotherapy and those with an incomplete follow up, were excluded. We analyzed and compared the visual status before and after the beginning of DA treatment.
Thirty one patients aged 8 to 59 years, were included. Eighteen patients (58%) had visual impairment at the moment of diagnosis (group 1) and 13 had no alterations (group 2). Mean follow up was 36.5 months. Fifteen patients from group 1 (83%) had visual improvement, two remained stable (11 %) and one had a visual deterioration (6%). In group 2, only one non-compliant patient had a visual deterioration.
DAs are effective in the management of neuro-ophthalmic complications associated to macroprolactinomas and should be considered as first choice therapy in these tumors.