目的　总结临床所诊治的以视觉损伤为首发症状的10例中老年人无功能垂体腺瘤的临床特点和内镜下经蝶切除的疗效。  方法　收集经眼科视力、视野检查及CT检查确诊的10例中老年人无功能垂体腺瘤患者的临床资料，所有患者均在确诊后在一周内接受了内镜下经蝶手术切除，并经鼻科、眼科、内分泌科随访半年以上。  结果　发病一个月以内确诊的5例患者，术后1周视力恢复良好，视野也有明显恢复。发病半年以上，并被误诊漏诊、严重视觉受损的5例患者，术后1周无恢复表现；术后半年，有1例恢复至光感，其它4例仍无任何恢复。  结论　无功能腺瘤经常以视觉受损为首发症状，并且无明显的内分泌表现；在中老年人尤其容易误诊，应提高警惕。对于及时确诊的病例，内镜下经蝶手术疗效明显，并发症少，值得临床推广。

Objective　To report the clinical experience and outcome about ten middle-aged and old patients with visual deterioration rooting in nonfunctional pituitary adenoma.　Methods　The ophthalmologist diagnosed 10 cases pituitary adenoma patients who main complained of sudden or progressive damage on visual acuity and visual field. All the patients underwent surgical resection under nasal endoscopy; and the follow up lasted for at least half year.　Results　5 of the 10 patients who were respectively diagnosed within 1 month after onset of visual damage have excellent postoperative visual recovery. 5 other patients who had were misdiagnosed for longer than 6 months and severe visual damage had nothing visual improvement at postoperative one week, and four of five hadn't any visual improvement until 6 months postoperatively except one had improved to light perception.　Conclusions　Visual deterioration is often the only complaint of non-functional pituitary adenoma without any endocrine symptoms; this kind of tumor is inclined to be misdiagnosed. For the patients who are timely and accurately diagnosed, the clinical effect of endoscopic transsphenoidal surgical removal is reliable for its lower complication, which is valuable to extend in clinic.