Treatment of Non-Functioning Pituitary Macroadenoma Compressing the Optic Chiasm or Causing Visual Symptoms

This protocol applies to non-functioning pituitary macroadenoma that is abutting or compressing the optic chiasm, or where neuro-ophthalmological manifestations are directly attributed to the tumour. Involvement of the visual pathway defines the clinical priority in this setting.

Multiple international guidelines and consensus statements recommend surgical intervention for macroadenomas in this scenario. Surgery is also considered when the tumour is associated with loss of pituitary function.

The recommended intervention is a surgical approach directed at the macroadenoma. The specific technique, perioperative management, and follow-up pathway are detailed in the full protocol.

Complete regimen — procedural specifics, sequencing, and post-operative criteria — available in the structured protocol below.

The primary outcome target is normalization or meaningful improvement of visual fields following the intervention. Visual field recovery serves as the principal marker of treatment success.