We aimed to investigate the predictive value of retinal thickness measured by optical coherence tomography (OCT) and mass biometrics measured using magnetic resonance image (MRI) for visual recovery after surgery for removal of a mass compressing the optic chiasm.
Methods
Consecutive patients who showed typical temporal visual field defect (VFD) with respect to the vertical meridian due to a chiasmal compressive mass and who underwent mass removal surgery were recruited. Ophthalmic examination was performed preoperatively and postoperatively. Retinal thickness was measured by the Cirrus OCT. The height and size of the mass and suprasellar extension (SSE) in both the sagittal and coronal planes were evaluated. Patients were divided into two groups based on the improvement in VFD (mean deviation [MD] change ≥ 5 dB: group R; others: group NR) and clinical characteristics were compared.
Results
Fifteen patients were included in the study. Eight (53.3%) patients were allocated into group R and others (7 patients, 46.7%) into group NR. Age, sex, initial visual acuity, initial MD was not different between the two groups. The retinal thicknesses were not different while tumor height, volume, and both sagittal and coronal SSE were significantly different between the two groups. (p = 0.029, 0.014, <0.001, and <0.001, respectively) All MRI parameters showed significant predictive value for the degree of MD recovery.
Conclusion
MRI showed better predictive value than OCT in predicting postoperative VFD recovery in patients with temporal VFDs due to chiasmal compressive disorder.
ChansonPRaverotGCastinettiF, et al. Management of clinically non-functioning pituitary adenoma. Ann Endocrinol (Paris) 2015; 76: 239–247. 2015/06/15.
2.
CiricIMikhaelMStaffordT, et al.Transsphenoidal microsurgery of pituitary macroadenomas with long-term follow-up results. J Neurosurg1983; 59: 395–401.
3.
LuomarantaTRaappanaASaarelaV, et al. Factors affecting the visual outcome of pituitary adenoma patients treated with endoscopic transsphenoidal surgery. World Neurosurg2017; 105: 422–431. 2017/06/07.
4.
CohenARCooperPRKupersmithMJ, et al. Visual recovery after transsphenoidal removal of pituitary adenomas. Neurosurgery1985; 17: 446–452. 1985/09/01.
5.
BarzaghiLRMedoneMLosaM, et al. Prognostic factors of visual field improvement after trans-sphenoidal approach for pituitary macroadenomas: review of the literature and analysis by quantitative method. Neurosurg Rev2012; 35: 369–378; discussion 378–369. 2011/11/15.
6.
GanLMaJFengF, et al. The predictive value of suprasellar extension for visual function evaluation in Chinese patients with nonfunctioning pituitary adenoma with optic chiasm compression. World Neurosurg2018; 116: e960–e967. 2018/06/02.
7.
TrautmannJCLawsERJr.Visual status after transsphenoidal surgery at the mayo clinic, 1971–1982. Am J Ophthalmol1983; 96: 200–208. 1983/08/01.
8.
LundströmMFrisenL. Atrophy of optic nerve fibres in compression of the chiasm: degree and distribution of ophthalmoscopic changes. Acta Ophthalmol1976; 54: 623–640.
9.
MonteiroMLLealBCRosaAA, et al. Optical coherence tomography analysis of axonal loss in band atrophy of the optic nerve. Br J Ophthalmol2004; 88: 896–899. 2004/06/19.
10.
MwanzaJ-COakleyJDBudenzDL, et al.Macular ganglion cell–inner plexiform layer: automated detection and thickness reproducibility with spectral domain–optical coherence tomography in glaucoma. Invest Ophthalmol Visual Sci2011; 52: 8323–8329.
11.
MoonCHLeeSHKimBT, et al. Diagnostic ability of retinal nerve fiber layer thickness measurements and neurologic hemifield test to detect chiasmal compression. Invest Ophthalmol Vis Sci2012; 53: 5410–5415. 2012/07/21.
12.
CennamoGAuriemmaRSCardoneD, et al.Evaluation of the retinal nerve fibre layer and ganglion cell complex thickness in pituitary macroadenomas without optic chiasmal compression. Eye (London, England)2015; 29: 797–802.
13.
MonteiroMLCosta-CunhaLVCunhaLP, et al. Correlation between macular and retinal nerve fibre layer Fourier-domain OCT measurements and visual field loss in chiasmal compression. Eye (Lond) 2010; 24: 1382–1390. 2010/05/01.
14.
MoonCHHwangSCKimBT, et al. Visual prognostic value of optical coherence tomography and photopic negative response in chiasmal compression. Invest Ophthalmol Vis Sci2011; 52: 8527–8533. 2011/10/01.
15.
MoonCHHwangSCOhnYH, et al. The time course of visual field recovery and changes of retinal ganglion cells after optic chiasmal decompression. Invest Ophthalmol Vis Sci2011; 52: 7966–7973. 2011/09/29.
JacobMRaverotGJouanneauE, et al. Predicting visual outcome after treatment of pituitary adenomas with optical coherence tomography. Am J Ophthalmol2009; 147: 64–70e62. 2008/09/09.
18.
HoRWHuangHMHoJT. The influence of pituitary adenoma size on vision and visual outcomes after trans-sphenoidal adenectomy: a report of 78 cases. J Korean Neurosurg Soc2015; 57: 23–31.
19.
LeeJPParkIWChungYS. The volume of tumor mass and visual field defect in patients with pituitary macroadenoma. Korean J Ophthalmol2011; 25: 37–41. 2011/02/26.
20.
WangHSunWFuZ, et al. The pattern of visual impairment in patients with pituitary adenoma. J Int Med Res2008; 36: 1064–1069. 2008/10/04.
21.
SuhHChoiHJeonH. The radiologic characteristics and retinal thickness Are correlated With visual field defect in patients With a pituitary mass. J Neuroophthalmol2021; 41: e541–e547.
22.
FindlayGMcFadzeanRTeasdaleG. Recovery of vision following treatment of pituitary tumours; application of a new system of assessment to patients treated by transsphenoidal operation. Acta Neurochir1983; 68: 175–186.
23.
IkedaHYoshimotoT. Visual disturbances in patients with pituitary adenoma. Acta Neurol Scand1995; 92: 157–160. 1995/08/01.
24.
LeeJKimSWKimDW, et al. Predictive model for recovery of visual field after surgery of pituitary adenoma. J Neurooncol2016; 130: 155–164. 2016/10/21.
25.
Danesh-MeyerHVPapchenkoTSavinoPJ, et al. In vivo retinal nerve fiber layer thickness measured by optical coherence tomography predicts visual recovery after surgery for parachiasmal tumors. Invest Ophthalmol Vis Sci2008; 49: 1879–1885. 2008/02/12.
26.
ChungYSNaMYooJ, et al. Optical coherent tomography predicts long-term visual outcome of pituitary adenoma surgery: new perspectives From a 5-year follow-up study. Neurosurgery2020; 88: 106–112. 2020/08/01. DOI: 10.1093/neuros/nyaa318
27.
QiaoNYeZShouX, et al. Discrepancy between structural and functional visual recovery in patients after trans-sphenoidal pituitary adenoma resection. Clin Neurol Neurosurg2016; 151: 9–17. 2016/10/12.
28.
MonteiroMLZambonBKCunhaLP. Predictive factors for the development of visual loss in patients with pituitary macroadenomas and for visual recovery after optic pathway decompression. Canadian journal of ophthalmology Journal canadien d’ophtalmologie2010; 45: 404–408. 2010/07/22.
29.
RivoalOBrezinAPFeldman-BillardS, et al. Goldmann perimetry in acromegaly: a survey of 307 cases from 1951 through 1996. Ophthalmology2000; 107: 991–997. 2000/05/16.
30.
SchmalischKMilianMSchimitzekT, et al. Predictors for visual dysfunction in nonfunctioning pituitary adenomas - implications for neurosurgical management. Clin Endocrinol (Oxf)2012; 77: 728–734. 2012/07/04.
31.
KerrisonJBLynnMJBaerCA, et al. Stages of improvement in visual fields after pituitary tumor resection. Am J Ophthalmol2000; 130: 813–820. 2000/12/22.
32.
SmithKJBlakemoreWFMcDonaldWI. The restoration of conduction by central remyelination. Brain : a journal of neurology1981; 104: 383–404. 1981/06/01.
33.
KayanAEarlCJ. Compressive lesions of the optic nerves and chiasm. Pattern of recovery of vision following surgical treatment. Brain : a journal of neurology1975; 98: 13–28. 1975/03/01.
