Retinal nerve fiber layer changes: A predictor of visual function recovery in pituitary adenomas

Abstract

Abstract Objective To evaluate and correlate retinal nerve fiber layer changes on optical coherence tomography (OCT) with visual functions in pituitary adenomas in order to define OCT changes prognostic for visual recovery after neurosurgery. Methods Thirty-nine eyes of twenty patients undergoing surgical resection of pituitary adenomas were prospectively assessed by a detailed ophthalmological, radiological, and neurological examination including measurement of visual acuity, color vision, contrast sensitivity, stereoacuity, and visual field evaluation. Retinal nerve fiber layer thickness measurements were performed using OCT preoperatively and 6 weeks after surgery. Results After surgery, no significant change in visual acuity ( p = 0.067, Wilcoxon signed-rank test), stereoacuity ( p p = 0.52, paired t test) was noted. Significant improvement was observed in contrast sensitivity ( p = 0.001, paired t test), color vision ( p = 0.03, McNemar) and visual fields ( p p = 0.009, Fischer's exact test), contrast ( p p Conclusion In vivo retinal nerve fiber layer thickness measurement can accurately predict recovery of visual fields, contrast sensitivity, and color vision in pituitary adenomas after neurosurgery. Nasal quadrant retinal nerve fiber layer thickness is the most important prognostic factor in visual function recovery. Stereoacuity may be the earliest visual parameter to be affected.