Zhang X, Ma J, Wang Y H, Gan L Y, Li L, Wang X Q, Li D H, Xing B, Feng M, Zhu H J, Lu L, Feng F, You H, Zhang Z H, Zhong Y
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Zhonghua Yan Ke Za Zhi. 2019 Mar 11;55(3):186-194. doi: 10.3760/cma.j.issn.0412-4081.2019.03.007.
To investigate the consequences of the thickness of ganglion cell layer (GCL) and visual field defect of non-functional pituitary adenoma with chiasm compression. A case control study. The study included 40 (80 eyes) non-functional pituitary adenoma patients in Peking Union Medical College Hospital from March 2015 to February 2017. Twenty patients (no visual field defect group, 40 eyes) of them were detected to be chiasm compressed or touched by the adenoma with no visual field defect detected, and the other 20 patients (visual field defect group, 40 eyes) were the sex-and-age matched pituitary adenoma patients with bitemporal heminopsia. This study also included 20 (control group, 40 eyes) sex-and-age matched healthy controls. The para-papillary retinal nerve fiber layer (RNFL) thickness in 6 quadrants including nasal, temporal, nasal superior, temporal superior, nasal inferior and temporal inferior as well as the macular GCL thickness and ganglion cell-inner plexiform layer (GCIPL) thickness in 4 quadrants including nasal superior, nasal inferior, temporal superior and temporal inferior were measured. The non-parametric test was used to compare the RNFL, GCL and GCIPL thickness among the three groups. The mean age among the three groups was (46±10) years and the difference among the three groups was not significant (0.88). The sex ratio of the three groups was 9∶11 (male∶female) and the difference among the three groups was not significant. The mean axial length among the three groups was (23.22±0.90) mm and the difference among the three groups was not significant (0.51). The thickness of para-papillary RNFL of temporal superior, temporal, nasal superior, nasal, nasal inferior quadrants and whole circumference was significantly thinner in the visual field defect group than the control group [(129.88±28.64) μm, (63.63±26.84) μm, (88.08±32.16) μm, (50.68±19.99) μm, (92.48±25.06) μm, and (85.00±20.65) μm . (141.10±18.95) μm, (79.12±16.78) μm, (113.68±21.28) μm, (69.67±14.23) μm, (117.80±31.32) μm, and (102.80±9.68) μm, 2.26, 3.06, 4.14, 4.84, 4.25, 4.88, all 0.05]. In the nasal quadrant, the para-papillary RNFL of the no visual field defect group was significantly thinner compared with the control group [(61.45±9.83) μm . (69.67±14.23) μm, 2.97, 0.05]. The total GCL thickness was (30.48±5.42) μm in the visual field defect group, (31.35±2.77) μm in the no visual field defect group, thinner than that in the control group [(33.32±2.92) μm, 2.92, 3.62; both 0.05]. The total GCIPL thickness showed no significant difference among the three groups (0.07). In the superior and inferior temporal quadrants, the GCL and GCIPL thickness showed no significant difference among the three groups (all 0.05). In the superior and inferior nasal quadrants, the GCL thickness was (29.41±5.97) μm, and (28.47±5.13) μm in the visual field defect group, (31.15±3.27) μm and (30.61±2.96) μm in the no visual field defect group, and (34.23±3.16) μm and (32.97±2.78) μm in the control group. The GCL thickness in the nasal quadrant was thinner in the visual field defect group (4.45, 4.82)and the no visual field defect group(4.23, 3.63) than in the control group (all 0.01). However, no significant difference in GCL thickness was detected between the visual field defect group and the no visual field defect group (both 0.05). In the superior and inferior nasal quadrants, the GCIPL thickness was (54.06±10.50) μm and (51.77±9.18) μm in the visual field defect group, (58.03±4.00) μm and (56.23±5.37) μm in the no visual field defect group, and (62.26±7.11) μm and (59.39±6.64) μm in the control group. The GCIPL thickness was thinner in the nasal quadrant in the visual field defect group than in the control group (3.95, 4.20, both 0.01). Only in the Superior nasal quadrant, the GCIPL was significantly thinner in the no visual field defect group than the control group (3.25, 0.01). The optic GCL may get thinner in pituitary nonfunctional adenoma with chiasm compression patients without the RNFL layer thinning and visual field defect. -.
探讨非功能性垂体腺瘤压迫视交叉时神经节细胞层(GCL)厚度与视野缺损的关系。病例对照研究。研究纳入2015年3月至2017年2月在北京协和医院就诊的40例(80只眼)非功能性垂体腺瘤患者。其中20例(无视野缺损组,40只眼)腺瘤压迫或触及视交叉但未检测到视野缺损,另外20例(视野缺损组,40只眼)为年龄和性别匹配的双颞侧偏盲垂体腺瘤患者。本研究还纳入20例(对照组,40只眼)年龄和性别匹配的健康对照者。测量鼻侧、颞侧、鼻上、颞上、鼻下、颞下6个象限的旁乳头视网膜神经纤维层(RNFL)厚度以及鼻上、鼻下、颞上、颞下4个象限的黄斑GCL厚度和神经节细胞 - 内丛状层(GCIPL)厚度。采用非参数检验比较三组间RNFL、GCL和GCIPL厚度。三组平均年龄为(46±10)岁,三组间差异无统计学意义(0.88)。三组性别比为9∶11(男∶女),三组间差异无统计学意义。三组平均眼轴长度为(23.22±0.90)mm,三组间差异无统计学意义(0.51)。视野缺损组颞上、颞侧、鼻上、鼻侧、鼻下象限及全周的旁乳头RNFL厚度均显著低于对照组[(129.88±28.64)μm,(63.63±26.84)μm,(88.08±32.16)μm,(50.68±19.99)μm,(92.48±25.06)μm,(85.00±20.65)μm。(141.10±18.95)μm,(79.12±16.78)μm,(113.68±21.28)μm,(69.67±14.23)μm,(117.80±31.32)μm,(102.80±9.68)μm,2.26,3.06,4.14,4.84,4.25,4.88,均P<0.05]。在鼻侧象限,无视野缺损组的旁乳头RNFL厚度显著低于对照组[(61.45±9.83)μm。(69.67±14.23)μm,2.97,P<0.05]。视野缺损组GCL总厚度为(30.48±5.42)μm,无视野缺损组为(31.35±2.77)μm,均低于对照组[(33.32±2.92)μm,2.92,3.62;均P<0.05]。三组GCIPL总厚度差异无统计学意义(P = 0.07)。在颞上、颞下象限,三组GCL和GCIPL厚度差异无统计学意义(均P>0.05)。在鼻上、鼻下象限,视野缺损组GCL厚度为(29.41±5.97)μm和(28.47±5.13)μm,无视野缺损组为(31.15±3.27)μm和(30.61±2.96)μm,对照组为(34.23±3.16)μm和(32.97±2.78)μm。视野缺损组和无视野缺损组鼻侧象限的GCL厚度均低于对照组(4.45,4.82和4.23,3.63;均P<0.01)。然而,视野缺损组与无视野缺损组之间GCL厚度差异无统计学意义(均P>0.05)。在鼻上、鼻下象限,视野缺损组GCIPL厚度为(