Related Experiment Video
Updated: Apr 14, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
20.2K
Optical coherence tomography predicts visual outcome for pituitary tumors
Helen V Danesh-Meyer1, Aaron Wong2, Taras Papchenko2
1Department of Ophthalmology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Department of Surgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville, VIC, Australia.
Summary
Pre-operative optical coherence tomography (OCT) of the retinal nerve fibre layer (RNFL) predicts long-term visual recovery after pituitary decompression surgery. Patients with normal RNFL thickness demonstrate better visual outcomes and a greater propensity for recovery.
Area of Science:
- Ophthalmology
- Neuroscience
- Medical Imaging
Background:
- Pituitary tumors can cause chiasmal compression, leading to visual impairment.
- Optical coherence tomography (OCT) of the retinal nerve fibre layer (RNFL) shows prognostic value for visual outcomes after surgery for chiasmal compression.
- Long-term visual recovery patterns after pituitary decompression require further investigation.
Purpose of the Study:
- To evaluate the long-term relationship between pre-operative retinal nerve fibre layer (RNFL) thickness measured by OCT and visual recovery after pituitary decompression.
- To assess the prognostic value of RNFL thickness for visual field defects and visual acuity over time.
Main Methods:
- A cohort of 107 patients undergoing pituitary decompression were followed up at three time points: pre-operative, 6-10 weeks post-operative, and 9-15 months post-operative.
- Retinal nerve fibre layer (RNFL) thickness was measured using optical coherence tomography (OCT).
- Visual field defects (mean deviation [MD]) and visual acuity (VA) were assessed at each follow-up visit.
Main Results:
- Patients with thin pre-operative RNFL had more severe visual field defects (MD -9.22 dB) compared to those with normal RNFL (MD -3.96 dB).
- Greatest visual improvement for thin RNFL patients occurred between 6-10 weeks and 9-15 months post-operatively (MD change from -9.8 dB to -3.4 dB).
- Normal RNFL patients showed the most significant visual improvement between pre-operative and 6-10 weeks post-operatively (MD change from -4.8 dB to -2.0 dB).
- At long-term follow-up, 81.0% of normal RNFL eyes achieved an MD of -2.00 dB, versus 37.1% of thin RNFL eyes.
- 97.5% of normal RNFL eyes achieved VA of 6/12 or better compared to 88.2% of thin RNFL eyes at final follow-up.
Conclusions:
- Pre-operative OCT RNFL thickness is a significant predictor of long-term visual recovery following surgical decompression for pituitary lesions.
- Patients with normal RNFL thickness exhibit a higher propensity for visual recovery and better long-term visual outcomes.
- While most visual recovery occurs within the first 6-10 weeks, the benefits of normal RNFL thickness persist throughout long-term follow-up.
More Related Videos
Related Concept Videos
01:25Glaucoma: Overview
1.7K
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
1.7K
01:27Open Angle Glaucoma: Treatment
1.1K
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
1.1K
01:27Imaging Studies III: Computed Tomography
790
DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
790
01:28Angle Closure Glaucoma: Treatment
1.7K
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
1.7K