The natural history of asymptomatic NFPAs with proven optic nerve compression on MRI detected between 2000 and 2016 from two institutions was studied retrospectively. The endpoint was new endocrinopathy or neurological impairments, and the patients were followed up with regular endocrinological, ophthalmological, and radiographic examinations. Asymptomatic nonfunctioning pituitary adenomas with optic nerve compression exhibited more indolent behaviour than expected, according to this study. These tumours, despite their benign nature, require tailored therapy and lifelong radiological and endocrinological monitoring.These findings, while only evaluated in a few cases, contribute to the literature, and this level of effort has never been tried before.

The study included 81 patients, with a median age of 58.0 years at diagnosis and a follow-up period of 60.0 months. The mean initial and last measured tumour diameters were 23.7 mm and 26.2 mm (mean SD), respectively. Tumor growth was found in 51 (63.0 percent) of the patients, but visual impairment was recorded in 14 (17.3%). All of the patients’ symptoms improved after surgery.In asymptomatic NFPAs with verified optic nerve compression on MRI, neuroendocrinological degeneration was uncommon and might be reversed with surgery and early identification on regular follow-up. As a result, cautious care of these tumours may be a viable option. Tumors that have invaded the cavernous sinus require close monitoring.

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