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Microvascular Changes in Pituitary Adenoma Correlate with Structural Measurements and Visual Field Loss
Yaying Chen1,2, Xiaojiao Li2, Xiangyuan Song2
1Department of Ophthalmology, Huadong Hospital, Fudan University School of Medicine, Shanghai, People's Republic of China.
Purpose:
This study aimed to determine the relationship among microvascular changes, retinal nerve fiber layer (RNFL) thickness, and visual field loss in pituitary adenoma (PA) patients.
Patients And Methods:
Optic disc and macular vessel densities were measured, using optical coherence tomography angiography (OCTA) in the eyes from PA patients with radiographic chiasmal compression. Comparisons of retinal microvascular and structural parameters were conducted between PA patients and age/sex-matched healthy controls. The PA group was subdivided into PA with temporal visual field defects (perimetric PA) and PA without visual field defect (preperimetric PA) groups. The study determined correlation between microvascular parameters and optic nerve damage, including visual field and structural measurements. Subgroup analyses were performed to distinguish the different microcirculation characteristics of the perimetric PA eyes and preperimetric PA eyes.
Results:
Forty-five eyes from 40 PA patients and 24 eyes from 24 healthy controls were recruited prospectively. Eyes in the perimetric PA group had significantly decreased optic disc vessel density but slightly increased macular vessel density at superficial retinal capillary plexus (SCP) level. Eyes in the preperimetric PA group had significantly increased macular vessel density at SCP level. Optic disc vessel density was inversely correlated with visual field mean deviation and positively correlated with RNFL thickness.
Conclusion:
Significantly decreased optic disc vessel density in the perimetric stage but increased SCP macular vessel density in the preperimetric stage were found in PA patients. Our data suggest that increased SCP macular vessel density may serve as an early biomarker of preperimetric PA eyes, while decreased optic disc vessel density could be a late biomarker of perimetric PA eyes. Optic disc vessel density was correlated with RNFL thickness and visual field loss in PA eyes. OCTA is a useful tool to detect retinal microvascular changes and access the severity of neural impairments in chiasmal compression caused by PA.
