Segmented retinal analysis in pituitary adenoma with chiasmal compression: A prospective comparative study

• Published in: Indian journal of ophthalmology Vol. 69; no. 9; pp. 2378 - 2384
• Main Authors: Agarwal, Rachna, Jain, Vaibhav, Singh, Shalini, Charlotte, Akshata, Kanaujia, Vikas, Mishra, Prabhakar, Sharma, Kumudini
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.09.2021; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Adenoma; chiasmal compression; Compression; Confidence intervals; Diagnosis; ganglion cell complex thickness; ganglion cell layer-inner plexiform laye; Humans; Medical examination; Nerve Fibers; Optic Chiasm - diagnostic imaging; Optic nerve; Original; Patients; Pituitary; pituitary adenoma; Pituitary gland tumors; Pituitary Neoplasms - complications; Pituitary Neoplasms - diagnosis; Pituitary Neoplasms - surgery; Prospective Studies; Retina; Retinal Ganglion Cells; retinal nerve fiber layer; Tumors; Visual field; Visual pathways; India; ganglion cell layer-inner plexiform laye; visual field; pituitary adenoma; ganglion cell complex thickness; retinal nerve fiber layer; Chiasmal compression
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/ijo.IJO_2086_20

Purpose: The aim of this study was to determine the alteration in ganglion cell complex and its relationship with retinal nerve fiber layer (RNFL) thickness as measured by spectral-domain optical coherence tomography (OCT) in pituitary adenoma cases and also its correlation with visual field (VF). Methods: This is a prospective comparative study wherein detailed neuro-ophthalmic examination including perimetry, RNFL and ganglion cell layer inner plexiform layer (GCL-IPL) thickness were measured preoperatively in the cases of pituitary adenoma with chiasmal compression with visual symptoms and field changes who were planned for neuro-surgical intervention. These parameters were repeated 1 year after the surgery. GCL-IPL, RNFL parameters were compared with controls and were correlated with VF mean deviation (MD). The diagnostic power of GCL-IPL was tested using the receiver operating characteristic (ROC) curve. Healthy age and sex-matched controls without any ocular and systemic abnormality were taken for comparison. Results: Twenty-four patients qualified the inclusion criteria. A significant thinning of GCL-IPL (P = 0.002) and RNFL (P = 0.039) was noticed in the pituitary adenoma group. GCL-IPL (r = 0.780 P < 0.001) and RNFL (r = 0.669, P < 0.001) were significantly correlated with the MD. The ROC curve values of GCL-IPL were 0.859 (95% confidence interval 0.744% to 0.973) and of RNFL were 0.731 (95% confidence interval 0.585-0.877). The diagnostic ability of GCL-IPL was more as compared to the RNFL analysis, although it was statistically insignificant (P = 0.122). Conclusion: GCL-IPL measurements on the OCT are a sensitive tool to detect early anterior visual pathway changes in chiasmal compression for pituitary adenoma patients.