Prognostic Utility of Optical Coherence Tomography for Long-Term Visual Recovery Following Pituitary Tumor Surgery

Wang, Michael T.M.; King, James; Symons, R.C. Andrew; Stylli, Stanley S.; Meyer, Joos; Daniell, Mark; Savino, Peter J.; Kaye, Andrew H.; Danesh‐Meyer, Helen V.

doi:10.1016/j.ajo.2020.06.004

Cited by 25 publications

(31 citation statements)

References 46 publications

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“…In accordance with the results reported in previous studies [35,18,28,27,10], our research showed that preoperative OCT parameters can effectively predict postoperative visual outcome following optical nerves decompression. Notablely, increased inferior cpRNFL thickness was signi cantly associated with higher odds of VF recovery and maintenance (P=0.046) in present study, which was consistent with the results reported in the earlier literature [33,23]. In addition, greater temporal cpRNFL thickness was con rmed as a signi cant favorable factor for VA recovery and maintenance (P=0.035) in our study, which was similar to the ndings by Kawaguchi and colleagues [19].…”

Section: Discussionsupporting

confidence: 92%

“…pointed out that the changes in retinal structure were closely related to peripapillary RNFL thinning and functional outcomes following surgery for pediatric craniopharyngiomas. Wang and his colleagues [33] demonstrated the predictive value of OCT parameters for visual outcome after pituitary tumor surgery. As far as we know, this is the rst study to systematically analyze the prognostic utility of OCT parameters for visual outcome after extended endoscopic endonasal surgery for adult craniopharyngiomas.…”

Section: Discussionmentioning

confidence: 99%

“…Optical coherence tomography (OCT) can serve as a noninvasive in vivo method to quantitatively and objectively measure cpRNFL thickness and mGCC parameters [33,28]. The clinical e ciency of OCT as a predictor of visual recovery after surgery for pituitary adenomas, meningioma or pediatric craniopharyngiomas has already been veri ed [28,11,17,10,33,24,22,3]. Differing from pituitary tumors and meningioma, craniopharyngiomas often directly adhere to optic nerves, with a higher risk of postoperative visual deterioration.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, investigating reliable predictive indicators of postoperative visual outcome may be bene cial for patients counseling on visual prognosis. However, there is limited evidence on the prognostic utility of OCT for visual outcome after surgery for adult craniopharyngiomas [33,10]. This is rst study to systematically evaluates the association between OCT parameters and visual outcome after the extended endoscopic endonasal surgery (EEES) for adult craniopharyngiomas.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Utility of Optical Coherence Tomography for Visual Outcome After Extended Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Qiao

et al. 2021

Preprint

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Optical coherence tomography (OCT) serving as a novel high resolution imaging technique can assess the retinal morphology. At present, a few studies are reported with limited evidence on the predictive value of OCT for visual outcome after optic nerve decompression. This study aims to utilize the largest series of adult craniopharyngiomas to evaluate the association between OCT parameters and visual outcome following the extended endoscopic endonasal surgery (EEES). From October 2018 to October 2020, one hundred and seventy eyes in 88 adult patients with craniopharyngiomas were retrospectively reviewed. Gross total resection was performed in 82 (93.2%) patients. The median follow-up time was 10.9 months. Our study showed that increased temporal circumpapillary retinal nerve fiber layer (cpRNFL) thickness was associated with higher odds of visual acuity (VA) improvement and maintenance (OR=1.070; P=0.035), and greater inferior cpRNFL thickness was significantly associated with visual field (VF) improvement and maintenance (OR=1.034; P=0.046). Tight adhesion was demonstrated as an independent adverse factor for either postoperative VA or VF (P=0.048, P=0.030, respectively). Receiver operating characteristic (ROC) analysis further verified the robustness of the prediction model either in VA (AUC=0.842; P<0.001) or VF (AUC=0.849; P<0.001). Preoperative OCT can effectively predict visual outcome after EEES for adult craniopharyngiomas. It can also serve as a reliable alternative to evaluate preoperative visual filed defects, especially for patients with lower compliance. Tight adhesion was confirmed as an independent risk factor for postoperative visual outcome. The OCT-based multivariable prediction models developed in present study may contribute to patient counseling on visual prognosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Utility of Optical Coherence Tomography for Visual Outcome After Extended Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Qiao

et al. 2021

Preprint

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“…[ 93 ] Similar findings have been replicated in thyroid eye disease looking at RNFL thickness as a predictor of surgical outcomes in individuals with significant visual field defects due to compressive optic neuropathy. [ 99 ] There is emerging evidence to suggest in some cases that nasal GCIPL thickness may have superior prognostic power to the RNFL in postoperative visual outcomes in sellar tumours. [ 100 ]…”

Section: Compressive Optic Neuropathies and The Optic Chiasmmentioning

confidence: 99%

Recent advances and future directions on the use of optical coherence tomography in neuro-ophthalmology

Vuong

Micieli

2021

Taiwan J Ophthalmol

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Optical coherence tomography (OCT) is a noninvasive imaging technique used to qualitatively and quantitatively analyze various layers of the retina. OCT of the retinal nerve fiber layer (RNFL) and ganglion cell–inner plexiform layer (GCIPL) is particularly useful in neuro-ophthalmology for the evaluation of patients with optic neuropathies and retrochiasmal visual pathway disorders. OCT allows for an objective quantification of edema and atrophy of the RNFL and GCIPL, which may be evident before obvious clinical signs and visual dysfunction develop. Enhanced depth imaging OCT allows for visualization of deep structures of the optic nerve and has emerged as the gold standard for the detection of optic disc drusen. In the evaluation of compressive optic neuropathies, OCT RNFL and GCIPL thicknesses have been established as the most important visual prognostic factor. There is increasing evidence that inclusion of OCT as part of the diagnostic criteria for multiple sclerosis (MS) increases its sensitivity. Moreover, OCT of the RNFL and GCIPL may be helpful in the early detection and monitoring the treatment of conditions such as MS and Alzheimer's disease. OCT is an important aspect of the neuro-ophthalmologic assessment and its use is likely to increase moving forward.

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Predicting visual recovery in pituitary adenoma patients post-endoscopic endonasal transsphenoidal surgery: Harnessing delta-radiomics of the optic chiasm from MRI

Yang¹,

Zheng²,

Huang³

et al. 2023

Eur Radiol

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Objectives To investigate whether morphological changes after surgery and delta-radiomics of the optic chiasm obtained from routine MRI could help predict postoperative visual recovery of pituitary adenoma patients. Methods A total of 130 pituitary adenoma patients were retrospectively enrolled and divided into the recovery group (n = 87) and non-recovery group (n = 43) according to visual outcome 1 year after endoscopic endonasal transsphenoidal surgery. Morphological parameters of the optic chiasm were measured preoperatively and postoperatively, including chiasmal thickness, deformed angle, and suprasellar extension. Delta-radiomics of the optic chiasm were calculated based on features extracted from preoperative and postoperative coronal T2-weighted images, followed by machine learning modeling using least absolute shrinkage and selection operator wrapped with support vector machine through fivefold cross-validation in the development set. The delta-radiomic model was independently evaluated in the test set, and compared with the combined model that incorporated delta-radiomics, significant clinical and morphological parameters. Results Postoperative morphological changes of the optic chiasm could not significantly be used as predictors for the visual outcome. In contrast, the delta-radiomics model represented good performances in predicting visual recovery, with an AUC of 0.821 in the development set and 0.811 in the independent test set. Moreover, the combined model that incorporated age and delta-radiomics features of the optic chiasm achieved the highest AUC of 0.841 and 0.840 in the development set and independent test set, respectively. Conclusions Our proposed machine learning models based on delta-radiomics of the optic chiasm can be used to predict postoperative visual recovery of pituitary adenoma patients. Clinical relevance statement Our delta-radiomics-based models from MRI enable accurate visual recovery predictions in pituitary adenoma patients who underwent endoscopic endonasal transsphenoidal surgery, facilitating better clinical decision-making and ultimately improving patient outcomes. Key Points • Prediction of the postoperative visual outcome for pituitary adenoma patients is important but challenging. • Delta-radiomics of the optic chiasm after surgical decompression represented better prognostic performances compared with its morphological changes. • The proposed machine learning models can serve as novel approaches to predict visual recovery for pituitary adenoma patients in clinical practice.

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Prognostic Utility of Optical Coherence Tomography for Long-Term Visual Recovery Following Pituitary Tumor Surgery

Cited by 25 publications

References 46 publications

Prognostic Utility of Optical Coherence Tomography for Visual Outcome After Extended Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Prognostic Utility of Optical Coherence Tomography for Visual Outcome After Extended Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Recent advances and future directions on the use of optical coherence tomography in neuro-ophthalmology

Predicting visual recovery in pituitary adenoma patients post-endoscopic endonasal transsphenoidal surgery: Harnessing delta-radiomics of the optic chiasm from MRI

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