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Bozzi MT, Mallereau CH, Todeschi J, Baloglu S, Ardellier FD, Romann J, Trouve L, Bocsksei Z, Alcazar J, Dannhoff G, Bahougne T, Goichot B, Chibbaro S, Cebula H. Is the OCT a predictive tool to assess visual impairment in optic chiasm compressing syndrome in pituitary macroadenoma? A prospective longitudinal study. Neurosurg Rev 2024; 47:50. [PMID: 38228894 DOI: 10.1007/s10143-024-02280-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024]
Abstract
Visual dysfunction is a prevalent symptom in patients with non-functioning pituitary macroadenoma (NFPM); the role of OCT in such patients has not been yet determined. This is a prospective longitudinal observational study over a period of 6 years, on 20 patients presenting a radiological compression of the optic chiasma without visual acuity (VA) and visual field (VF) disturbances. The primary endpoint was to evaluate the impact of NFPA on neuro-axonal loss by measuring RNFL thickness using OCT at inclusion (T0), 12 months (T1), 24 months (T2), and 36 months (T3), respectively. The secondary endpoint was to monitor the evolution of OCT over time and assess any relationship between the degree of OCT alteration and the degree of radiological and clinical optic chiasm compression syndrome. Among the 20 patients included, eight (40%) showed an altered RNFL-OCT at diagnosis, while the remaining 12 (60%) showed a normal pattern. During a mean ophthalmologic follow-up of 60 months, 4 patients (20%) presented an asymptomatic reduction of RNFL-OCT thickness although all 20 had a VA/VF stable. To our knowledge, this study represents the first attempt to longitudinally evaluate the natural history and evolution of RNFL-OCT in patients with radiologically asymptomatic chiasmatic compression syndrome. The results do not clearly demonstrate the role of the OCT as an early prognostic factor for visual dysfunction.
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Affiliation(s)
| | - Charles-Henry Mallereau
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France.
| | - Julien Todeschi
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France
| | - Seyyid Baloglu
- Neuroradiology Unit, Strasbourg University Hospital, Strasbourg, France
| | | | - Julia Romann
- Department of Ophthalmology, Strasbourg University Hospital, Strasbourg, France
| | - Léa Trouve
- Department of Ophthalmology, Strasbourg University Hospital, Strasbourg, France
| | - Zsolt Bocsksei
- Department of Ophthalmology, Strasbourg University Hospital, Strasbourg, France
| | - Joffrey Alcazar
- Department of Ophthalmology, Strasbourg University Hospital, Strasbourg, France
| | - Guillaume Dannhoff
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France
| | - Thibault Bahougne
- Department of Endocrinology, Diabetes and Nutrition, Strasbourg University Hospital, Strasbourg, France
- Institute of Cellular and Integrative Neuroscience, UPR CNRS, 3212, Strasbourg, France
| | - Bernard Goichot
- Department of Endocrinology, Diabetes and Nutrition, Strasbourg University Hospital, Strasbourg, France
| | - Salvatore Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France
| | - Helene Cebula
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France
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Xia L, Wenhui J, Xiaowen Y, Wenfang X, Wei Z, Yanjun H, Xiaoyan P. Predictive value of macular ganglion cell-inner plexiform layer thickness in visual field defect of pituitary adenoma patients: a case-control study. Pituitary 2022; 25:667-672. [PMID: 35834154 DOI: 10.1007/s11102-022-01248-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The present study explored the association between preoperative macular ganglion cell-inner plexiform layer thickness (GCIPL) and retinal nerve fiber layer thickness (RNFL) measured by optical coherence tomography (OCT) and the recovery of visual field (VF) defect after surgery in pituitary adenoma patients. METHODS This case-control study included patients with pituitary adenoma in the Neurosurgery Department of Shanxi Provincial People's Hospital between October 2019 and June 2021. Cranial MRI examination, three-dimensional OCT, and VF testing (Humphrey Field Analyzer II750) were performed before and at 6months after the surgery. RESULTS Fifty-three pituitary adenoma patients (81 eyes) were enrolled; 15 patients (23 eyes) were in the visual field did not recover group (VFNR), and 38 patients (58 eyes) were in the visual field recovered group (VFR). The temporal RNFL (P = 0.002) and average RNFL (P = 0.009) in the VFNR group were significantly lower than in the VFR group. The superior nasal GCIPL (P = 0.001), inferior nasal GCIPL (P = 0.001) and average GCIPL (P = 0.01) were significantly lower in the VFNR group than in the VFR group (all P < 0.01).The multivariable logistic regression analysis showed that nasal inferior GCIPL was an independent risk factor for VF recovery (odds ratio (OR) = 1.376,95% confidence interval (CI):1.089-1.739,P = 0.007). In the received operating characteristics (ROC) analysis, the area under the ROC curve (AUROCs) was the highest for nasal inferior GCIPL (AUROC = 0.739). CONCLUSIONS In patients who underwent resection of pituitary adenoma, nasal inferior GCIPL was an independent risk factor of visual field defect recover after surgery.
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Affiliation(s)
- Li Xia
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmolgy and Visual Science Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No.17 Hougou Lane, Chongnei Street, 100005, Beijing, People's Republic of China
- Department of Ophthalmology, Shanxi Provincial People's Hospital, No.29 Twin Towers, YingZe District, 030000, Taiyuan, People's Republic of China
| | - Jia Wenhui
- Department of neurology, Shanxi Provincial People's Hospital, No.29 Twin Towers, YingZe District, 030000, Taiyuan, People's Republic of China
| | - Yang Xiaowen
- Infectious disease department, Shanxi Provincial People's Hospital, No.29 Twin Towers, YingZe District, 030000, Taiyuan, People's Republic of China
| | - Xie Wenfang
- Department of Ophthalmology, Shanxi Provincial People's Hospital, No.29 Twin Towers, YingZe District, 030000, Taiyuan, People's Republic of China
| | - Zhang Wei
- Department of Ophthalmology, Shanxi Provincial People's Hospital, No.29 Twin Towers, YingZe District, 030000, Taiyuan, People's Republic of China
| | - Hu Yanjun
- Department of nuclear magnetic, Shanxi Provincial People's Hospital, No.29 Twin Towers, YingZe District, 030000, Taiyuan, People's Republic of China
| | - Peng Xiaoyan
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmolgy and Visual Science Key Laboratory, Beijing Tongren Eye Center, Capital Medical University, No.17 Hougou Lane, Chongnei Street, 100005, Beijing, People's Republic of China.
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Eliseeva NM, Serova NK, Pitskhelauri DI, Kuchina OB, Kudieva ES. [Retrograde degeneration of visual pathway]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2021; 85:92-96. [PMID: 34951765 DOI: 10.17116/neiro20218506192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) gives the opportunity to examine retrograde degeneration of visual pathway damaged at various levels. OBJECTIVE To estimate OCT data on retrograde degeneration of visual pathway damaged at various levels. MATERIAL AND METHODS Ganglion cell layer (GCL) thickness was measured by OCT in 79 patients with visual pathway damaged at various levels and known duration of visual disturbances. Twenty-One patients were diagnosed with traumatic lesions of the optic nerves and/or chiasma. Fifty-eight patients had retro-genicular visual pathway damage. Thirty-three patients were examined for postoperative homonymous hemianopia after surgery for drug-resistant temporal lobe epilepsy. Twenty-five patients were diagnosed with occipital lobe damage following stroke (12 patients), surgery for arteriovenous malformation (11 patients) and traumatic brain injury (2 patients). All patients underwent assessment of visual acuity, automatic static perimetry, MRI/CT of the brain. Retinal ganglion cell complex was analyzed during OCT. RESULTS GCL thinning following anterior visual pathway damage was detected in 20 out of 21 patients after ≥22 days. In case of post-genicular visual pathway damage, GCL thinning was found in 25 out of 58 patients (9 out of 33 ones after surgery for temporal lobe epilepsy and 16 out of 25 patients with occipital lobe lesion). After surgery for temporal lobe epilepsy, minimum period until GCL thinning detection after previous visual pathway damage was 3 months, in case of occipital lobe lesion - 5 months. CONCLUSION Retrograde visual pathway degeneration is followed by GCL thinning and depends on the level of visual pathway lesion.
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Affiliation(s)
| | - N K Serova
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - O B Kuchina
- Burdenko Neurosurgical Center, Moscow, Russia
| | - E S Kudieva
- Burdenko Neurosurgical Center, Moscow, Russia
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