Segmented retinal analysis in pituitary adenoma with chiasmal compression: A prospective comparative study

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Pituitary adenomas can cause chiasmal compression, leading to visual field defects.
• Assessing the anterior visual pathway's integrity is crucial for managing these patients.

Purpose of the Study:

• To evaluate changes in the ganglion cell complex and retinal nerve fiber layer (RNFL) thickness using spectral-domain optical coherence tomography (OCT) in pituitary adenoma patients.
• To correlate these OCT findings with visual field (VF) parameters and assess their diagnostic power.

Main Methods:

• A prospective comparative study involving 24 pituitary adenoma patients undergoing neurosurgery.
• Preoperative and 1-year postoperative measurements of RNFL and ganglion cell layer inner plexiform layer (GCL-IPL) thickness via OCT.
• Correlation analysis with visual field mean deviation (MD) and receiver operating characteristic (ROC) curve analysis.

Main Results:

• Significant thinning of GCL-IPL (P = 0.002) and RNFL (P = 0.039) was observed in pituitary adenoma patients.
• Both GCL-IPL and RNFL thickness strongly correlated with VF mean deviation (MD).
• GCL-IPL demonstrated a higher diagnostic ability (ROC 0.859) compared to RNFL (ROC 0.731).

Conclusions:

• OCT-based GCL-IPL measurements are sensitive for detecting early anterior visual pathway alterations in pituitary adenoma patients with chiasmal compression.
• GCL-IPL analysis offers a valuable tool for monitoring disease progression and treatment response.