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Decoding visual pathway damage in pituitary macroadenomas: insights from retinal nerve fiber layer and visual field
Sevgi Tongal1, Fatma Poslu Karademir2, Ihsan Cakir2
1Department of Ophthalmology, Istanbul Beyoglu Eye Training And Research Hospital, University of Health Sciences, Bereketzade Neighborhood, Bereketzade Mosque Street, No:2, Beyoğlu, Istanbul, Turkey. sevgi.tongal@gmail.com.
International Ophthalmology
|June 5, 2026
Summary
Pituitary macroadenoma (PMA) patients show reduced retinal nerve fiber layer (RNFL) thickness and visual field (VF) defects. Combining VF testing and RNFL analysis improves monitoring of visual pathway involvement in PMA.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Pituitary macroadenomas (PMA) can compress the optic chiasm, leading to visual field defects.
- Assessing visual pathway involvement is crucial for managing PMA patients.
Purpose of the Study:
- To evaluate retinal nerve fiber layer (RNFL) thickness and visual field (VF) defects in patients with pituitary macroadenomas (PMA).
- To assess the utility of RNFL thickness and VF defects in monitoring visual pathway involvement in PMA.
Main Methods:
- Retrospective study of 31 PMA patients and 31 healthy controls.
- Comprehensive ophthalmological examinations including VF testing and RNFL thickness measurement via optical coherence tomography (OCT).
Main Results:
- PMA patients exhibited significantly lower mean RNFL thickness, particularly in nasal and temporal quadrants.
- Mean Visual Field Index was 77.34% and mean deviation was -7.43 dB in PMA patients (p < 0.05).
- Nasal RNFL fibers showed the most pronounced thinning.
Conclusions:
- Visual field testing is primary for assessing chiasmal involvement in PMA.
- RNFL analysis provides complementary structural information on axonal damage.
- Evaluating both VF and RNFL improves clinical assessment and follow-up of visual pathway involvement in PMA.
