Surgical versus non-surgical treatment for pituitary apoplexy: A systematic review and meta-analysis

Background: Pituitary apoplexy is a rare disease caused by a sudden hemorrhage into or infarction of the pituitary gland. Its optimal management remains controversial. The aim of this study was to compare the outcomes of surgical and non-surgical treatments for pituitary apoplexy. Methods: A systematic literature search was performed of MedLine, EmBase, the Cochrane Library, and the Web of Science for articles published between January 1992 and September 2014. Studies of the outcomes in consecutive patients that compared surgical intervention with non-surgical treatment for pituitary apoplexy were included. Results: Six studies met the inclusion criteria. As compared to the non-surgically treated patients, surgically treated patients had a significantly higher rate of recovery of ocular palsy and visual field (both P < 0.05). However, there was no significant difference in the recovery of visual acuity and pituitary function (P > 0.05) between the two groups. Conclusions: The findings of our study suggest that surgical intervention should be advocated for pituitary apoplexy patients with visual field defects and ocular palsy. (C) 2016 Elsevier B.V. All rights reserved.