Evaluation of the retinal nerve fibre layer and ganglion cell complex thickness in pituitary macroadenomas without optic chiasmal compression

Abstract

Purpose The aim of this prospective study was to measure the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and the ganglion cell complex (GCC) using spectral domain optical coherence tomography (SD-OCT) in a cohort of consecutive de novo patients with pituitary macroadenomas without chiasmal compression. Patients and methods Twenty-two consecutive patients with pituitary macroadenoma without chiasmal compression (16 men, 6 women, aged 45.2 ± 14.6 years, 43 eyes) entered the study between September 2011 and June 2013. Among them, 31.8% harboured a growth hormone-secreting pituitary adenoma, 27.3% a prolactin-secreting pituitary adenoma, 27.3% a corticotrophin-secreting pituitary adenoma, and 13.6% a non-secreting pituitary tumour. Eighteen subjects (nine females, nine males, mean age 36.47 ± 6.37 years; 33 eyes) without pituitary adenoma, with normal ophthalmic examination, served as controls. In both patients and controls, cpRNFL and GCC thicknesses were measured by SD-OCT. Results Patients were significantly older (P = 0.02) than controls. Best corrected visual acuity, intraocular pressure, colour fundus photography, and automatic perimetry test were within the normal range in patients and controls. Conversely, cpRNFL (P = 0.009) and GCC (Po0.0001) were significantly thinner in patients than in controls. The average GCC (r = 0.306, P = 0.046) significantly correlated with the presence of arterial hypertension. OCT parameters did not differ significantly between patients with a tumour volume above the median and those with a tumour volume below the median. Conclusion Pituitary macroadenomas, even in the absence of chiasmal compression, may induce GCC and retinal nerve fibre layer thinning. SD-OCT may have a role in the early diagnosis and management of patients with pituitary tumours.

Evaluation of retinal nerve fiber layer thickness in patients of pituitary adenomas with and without optic chiasmal compression

“…Our finding was not in agreement with the opinion that only chiasmal compression would cause visual pathway impairment. Our results were compatible with a prospective study carried out by Cennamo et al 17 . They found that up to 58% of patients suffering PA without chiasmal compression had GCC and cpRNFL loss, although their visual field and visual acuity was normal.…”

The Use of Optical Coherence Tomography in Chiasmal Compression

“…Útlak OC má vliv na vedení vzruchů zejména ve zkřížených vláknech zrakové dráhy a nejčastěji je diagnostikován přítomností defektu v temporální části zorného pole (ZP) [21,31,32]. K objektivizaci zrakových obtíží se využívá zejména vyšetření ZP, ačkoliv nemusí vždy jednoznačně odhalit patologii [4]. V posledních dekádách se častěji využívá optická koherenční tomografie (OCT) v diagnostice kompresivních lézí částí zrakové dráhy tvořené vlákny gangliových buněk.…”

“…Na druhé straně argumentační osy je například publikace Cennamo a spol. [4]. Při jasné absenci tlaku adenomů hypofýz naměřili patologické hodnoty RNFL i GCC svědčící pro kompresi OC u jedinců, kteří neměli žádná jiné onemocnění zrakového ústrojí.…”

Analysis of Retinal Layer Thicknesses and Their Clinical Correlation in Patients with Traumatic Optic Neuropathy

“…[ 7 ] The macular ganglion cell complex consists of three retinal layers, including the nerve fiber layer (NFL), the ganglion cell layer (GCL), and the inner plexiform layer (IPL) and can be measured by SD-OCT; thus, many trials have evaluated the macular ganglion cell complex using SD-OCT in patients with many optic nerve disorders. [ 8 – 12 ]…”