Abstract
PurposeTo quantitatively investigate the characteristics of eyes with pituitary adenoma presented by three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) using three common indices, including thickness, optical intensity ratio, and optical intensity attenuation coefficient (OIAC).MethodsThe SD-OCT database of 38 patients with pituitary adenoma and 39 normal controls were included in the study. Quadrantal and average measurements of thickness, optical intensity ratio, and OIAC were calculated for macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL) combined with inner plexiform layer (IPL) (GCIPL) and/or the collective ganglion cell complex (GCC). The parameters of patients and controls were compared by unpaired t-test and Mann-Whitney U-test. The relationships between the optical intensity ratio and the thickness of mRNFL and GCIPL were evaluated by Pearson’s correlation. Diagnostic performances of these indices were assessed using receiver operating characteristic (ROC) analysis.ResultsSignificant decreases in thickness existed in the mRNFL and nasal GCC of patients compared with controls (p-values of 0.000 to 0.039). Optical intensity ratios in the relevant retinal layers of patients were almost all lower than those of controls. In patients, optical intensities were increased in the mRNFL but decreased in the GCIPL along with an increase of retinal thicknesses. The OIAC measurements were significantly higher in the upper quadrants and global average of the mRNFL in patients. The areas under the ROC curves (AUC) obtained by global average mRNFL thickness was significantly greater than that of the global average OIAC in the mRNFL (p = 0.0265).ConclusionsThicknesses of the mRNFL and nasal GCC were significantly decreased in the retinas of patients with pituitary adenoma compared with controls. The differences of the optical intensity ratio and OIAC between patients and controls were not all statistically significant. Thickness was more sensitive than optical characteristics indices in distinguishing pituitary adenoma from controls.
Highlights
Visual dysfunction is one of the most common symptoms of pituitary adenoma, which is caused by direct compression to the optic chiasm or disturbances in the optic chiasm’s blood supply system [1,2,3,4]
Significant decreases in thickness existed in the macular retinal nerve fiber layer (mRNFL) and nasal ganglion cell complex (GCC) of patients compared with controls (p-values of 0.000 to 0.039)
Thicknesses of the mRNFL and nasal GCC were significantly decreased in the retinas of patients with pituitary adenoma compared with controls
Summary
Visual dysfunction is one of the most common symptoms of pituitary adenoma, which is caused by direct compression to the optic chiasm or disturbances in the optic chiasm’s blood supply system [1,2,3,4]. Optical coherence tomography (OCT), which provides noninvasive crosssectional imaging of the retinal layers [5], has been used to evaluate morphological changes in the retina induced by pituitary adenoma and to explore the relationship between the thickness of retinal layers and the visual functions of patients [6,7,8,9]. In addition to the morphological characteristics, the information obtained from OCT includes the light reflectivity profile presented as image intensities, which depend on differences in the optical backscattering properties of retinal tissue [10,11,12]. To the best of our knowledge, no study in the current literature has explored the optical characteristics of pituitary adenoma retina presented by OCT, even though the existence of pathological damage to retinal axons or ganglion cells due to this kind of tumor is well known
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