A comparison of macular ganglion cell and retinal nerve fibre layer optical coherence tomographic parameters as predictors of visual outcomes of surgery for pituitary tumours

Meyer, Joos; Diouf, Ibrahima; King, James; Drummond, Kate; Stylli, S S; Kaye, Andrew H.; Kalinčík, Tomáš; Danesh‐Meyer, Helen V.; Symons, R.C. Andrew

doi:10.1007/s11102-022-01228-w

Cited by 9 publications

(9 citation statements)

References 39 publications

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“…[26,31] Patients with thin preoperative RNFL tend to have suboptimal visual outcomes after surgery for pituitary tumors, and nasal RNFL thickness has been found to correlate with VF recovery. [32,33] Intraoperative VEP monitoring as an adjunct to endoscopic transsphenoidal surgery may provide useful prognostic information with regard to VA and VF improvement. [34,35] However, generation of a robust VEP signal is technically limited by its sensitivity to general anesthetic agents, and inconsistent use of threshold criteria.…”

Section: Discussionmentioning

confidence: 99%

Optico-chiasmatic distortions in pituitary adenomas: correlation between postoperative morphological reversal and follow-up functional visual recovery

Sarkar,

Thakar,

Sunil

et al. 2024

Preprint

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Purpose: To objectively correlate distortions of optic apparatus morphology in patients with visual outcomes in patients with pituitary adenomas undergoing transsphenoidal surgery. Methods: In this retrospective analysis, visual acuity (VA), visual field (VF) and total visual (TV) function was objectively scored in patients selected from an institutional cohort of pituitary adenomas. The following imaging measures of optico-chiasmatic morphology were recorded preoperatively, and at 3 months after surgery: chiasm area (CA), mid-chiasm height (CH), optic nerve-canal bending angle (BA), and optic nerve kinking angle (ONKA). Results: Seventy-one eyes were individually studied. VA, VF and TV scores significantly improved after surgery, both at the 3-month and at the 1-year follow-up visits (p<0.001). Craniocaudal tumor dimension was significantly associated with VA, VF and TV scores, both pre- and post-operatively. There were significant changes in CH (p<0.001), BA (p<0.001) and ONKA (p<0.001) at 3 months after surgery, but not in CA (p=0.061). Baseline VA, VF and TVS scores were positively correlated with preoperative CH and ONKA, while VF and TV scores also demonstrated significant negative correlations with preoperative BA. VF scores at 1-year follow-up were significantly correlated with preoperative and change in BA values, as well as with preoperative and change in ONKA values. Chiasm sag was noted in 45.8% of patients at one year follow-up, but was not associated with delayed visual deterioration in any case. Conclusions: Anatomic realignment of the optic apparatus at 3 months following transsphenoidal surgery month predicts VF scores at 1 year follow-up, but not VA or TV scores.

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Section: Discussionmentioning

confidence: 99%

Optico-chiasmatic distortions in pituitary adenomas: correlation between postoperative morphological reversal and follow-up functional visual recovery

Sarkar,

Thakar,

Sunil

et al. 2024

Preprint

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“…The use of OCT-measured peripapillary RNFL and macular thickness segmentation to quantify axonal loss has been previously documented in chiasm compressive lesions, as well as associations between RNFL/GCC thinning and visual field (Monteiro et al, 2014;Danesh-Meyer et al, 2015;Tieger et al, 2017;Meyer et al, 2022). In addition, Yum et al (2016) evidenced the diagnostic ability of global GCC for detecting early structural retinal changes following PMA chiasm compression, in which they selected the worse eye as the unit of analysis and detected that the superonasal sector of GCC showed a statistically significant detection rate in the PMA group.…”

Section: Cross-sectional Studymentioning

confidence: 98%

Bi-nasal sectors of ganglion cells complex and visual evoked potential amplitudes as biomarkers in pituitary macroadenoma management

Hernández-Echevarría¹,

Cuétara-Lugo²,

Pérez-Benítez³

et al. 2022

Front. Integr. Neurosci.

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The study aimed to evaluate the retinal ganglion cell structure using optical coherence tomography and the visual pathway function employing visual evoked potentials in the diagnosis and monitoring of patients with pituitary macroadenoma. A descriptive, cross-sectional, and longitudinal study (3 and 12 months follow-up) was conducted on forty-two patients. Thirty-five age-matched healthy controls were used in the cross-sectional one. Full neuro-ophthalmological evaluation (structural and functional) was carried out including global and segmented retinal nerve fiber layer/ganglion cell complex analysis and amplitude and latency of P100 component in the electrophysiology. Statistical data analysis was conducted with R version 3.6.3 and Python version 3.8. Associations were evaluated using Spearman’s correlations. Amplitude sensitivities were 0.999, and bi-nasal sectors of ganglion cell complex thickness specificities were 0.999. This structural parameter had the highest diagnostic value (area under curve = 0.923). Significant associations were found between bi-nasal sectors with amplitude at 12′ (rho > 0.7, p < 0.01) and median deviation of the visual field (rho > 0.5, p < 0.01) at 3 months. Pre-surgical values of bi-nasal sectors and amplitude can predict post-surgically median deviation and amplitude (Oz, 12′) at 3 months with r2 > 0.5. Bi-nasal sectors of ganglion cell complex and visual evoked potentials P100 amplitude are efficient biomarkers of visual pathway damage for pituitary macroadenoma patients’ management. Pre-surgical values of the bi-nasal sector and visual evoked potentials’ amplitude could help to predict the restoration of parvocellular pathway traffic after decompression.

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“…62 Another large 2-year prospective study of 108 patients showed that superior macular ganglion cell layer thickness was the best OCT parameter to predict long-term VF recovery after surgical resection. 64 Despite visual improvement, pRNFL and mGCIPL can show continued thinning after decompression. In a retrospective study of 113 patients with pituitary adenoma followed for 5 years, the VF stabilized at 3 months, while pRNFL thickness showed progressive thinning up to 36 months after surgery.…”

Section: Oct Imaging As a Prognostic Factor For Visual Outcomementioning

confidence: 99%

Section: Oct Imaging As a Prognostic Factor For Visual Outcomementioning

confidence: 99%

Ocular Optical Coherence Tomography in the Evaluation of Sellar and Parasellar Masses: A Review

et al. 2022

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Compression of the anterior visual pathways by sellar and parasellar masses can produce irreversible and devastating visual loss. Optical coherence tomography (OCT) is a noninvasive high-resolution ocular imaging modality routinely used in ophthalmology clinics for qualitative and quantitative analysis of optic nerve and retinal structures, including the retinal ganglion cells. By demonstrating structural loss of the retinal ganglion cells whose axons form the optic nerve before decussating in the optic chiasm, OCT imaging of the optic nerve and retina provides an excellent tool for detection and monitoring of compressive optic neuropathies and chiasmopathies due to sellar and parasellar masses. Recent studies have highlighted the role of OCT imaging in the diagnosis, follow-up, and prognostication of the visual outcomes in patients with chiasmal compression. OCT parameters of optic nerve and macular scans such as peripapillary retinal nerve fiber layer thickness and macular ganglion cell thickness are correlated with the degree of visual loss; additionally, OCT can detect clinically significant optic nerve and chiasmal compression before visual field loss is revealed on automated perimetry. Preoperative values of OCT optic nerve and macular parameters represent a prognostic tool for postoperative visual outcome. This review provides a qualitative analysis of the current applications of OCT imaging of the retina and optic nerve in patients with anterior visual pathway compression from sellar and parasellar masses. We also review the role of new technologies such as OCT-angiography, which could improve the prognostic ability of OCT to predict postoperative visual function.

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A comparison of macular ganglion cell and retinal nerve fibre layer optical coherence tomographic parameters as predictors of visual outcomes of surgery for pituitary tumours

Cited by 9 publications

References 39 publications

Optico-chiasmatic distortions in pituitary adenomas: correlation between postoperative morphological reversal and follow-up functional visual recovery

Optico-chiasmatic distortions in pituitary adenomas: correlation between postoperative morphological reversal and follow-up functional visual recovery

Bi-nasal sectors of ganglion cells complex and visual evoked potential amplitudes as biomarkers in pituitary macroadenoma management

Ocular Optical Coherence Tomography in the Evaluation of Sellar and Parasellar Masses: A Review

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