Public Health Department, Università degli Studi di Napoli "Federico II", Naples, Italy.
Division of Neurosurgery, Department of Neurosciences, Reproductive Sciences and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy.
PLoS One. 2021 Dec 2;16(12):e0260029. doi: 10.1371/journal.pone.0260029. eCollection 2021.
The purpose of this study was to investigate the changes in structural spectral-domain optical coherence tomography (SD-OCT), OCT Angiography (OCTA) parameters, and visual acuity, 1 year after endoscopic endonasal approach for the removal of an intra-suprasellar pituitary adenoma compressing optic chiasm and compare outcomes with 48 hours postoperative data.
Sixteen eyes of eight patients (4 males, 4 females, mean age 52 ± 11 years) were enrolled in this prospective study. The primary outcome was to evaluate the changes over time before and after surgery, analyzing the Best Corrected Visual Acuity (BCVA), Ganglion Cell Complex (GCC), Retinal Nerve Fiber Layer (RNFL) thicknesses, the retinal vessel density (VD) of Superficial Capillary Plexus (SCP), Deep Capillary Plexus (DCP), Radial Peripapillary Capillary (RPC) and the Foveal Avascular Zone (FAZ). The secondary outcome was to identify potential biomarkers that could predict visual acuity changes after 1-year follow-up.
When comparing SD-OCT and OCTA measurements obtained after 1 year with those observed 48 hours after surgery, GCC and RNFL were significantly improved. After a significant reduction at 48 hours, GCC thickness showed a significant increase at 1 year after surgery (p = 0.007), while a significant restoration of RNFL thickness was found at 1 year (p = 0.005), as well as the VD of SCP, DCP, and RPC values. FAZ area did not change over time. BCVA significantly improved at each time after surgery (p = 0.037, p = 0.013). A statistically significant correlation was found between the preoperative BCVA, VD of SCP, DCP, RPC, and the postoperative BCVA at 1 year (p = 0.017, p = 0.029, p = 0.031, p = 0.023).
SD-OCT and OCTA provide helpful information to identify the retinal structural and vascular improvements 1 year after surgery. OCTA parameters could serve as potential predictive markers for visual acuity recovery at long-term follow-up.
本研究旨在探讨内镜经鼻蝶入路切除对视神经交叉受压的鞍上垂体腺瘤患者术后 1 年结构谱域光相干断层扫描（SD-OCT）、OCT 血管造影（OCTA）参数和视力的变化，并与术后 48 小时的数据进行比较。
本前瞻性研究纳入了 8 例患者（4 名男性，4 名女性；平均年龄 52±11 岁）的 16 只眼。主要结局是评估手术前后随时间的变化，分析最佳矫正视力（BCVA）、节细胞复合体（GCC）、视网膜神经纤维层（RNFL）厚度、浅层毛细血管丛（SCP）、深层毛细血管丛（DCP）、放射状神经纤维层（RPC）和中心凹无血管区（FAZ）的视网膜血管密度（VD）。次要结局是确定可能预测术后 1 年视力变化的生物标志物。
与术后 48 小时相比，术后 1 年时 SD-OCT 和 OCTA 测量值显示 GCC 和 RNFL 显著改善。GCC 厚度在术后 48 小时显著降低后，在术后 1 年时显著增加（p=0.007），而 RNFL 厚度在术后 1 年时显著恢复（p=0.005），SCP、DCP 和 RPC 的 VD 值也显著增加。FAZ 面积无随时间变化。术后每次随访 BCVA 均显著改善（p=0.037，p=0.013）。术前 BCVA、SCP、DCP、RPC 的 VD 与术后 1 年时的 BCVA 之间存在显著相关性（p=0.017，p=0.029，p=0.031，p=0.023）。
SD-OCT 和 OCTA 提供了有价值的信息，可识别术后 1 年时视网膜结构和血管的改善。OCTA 参数可作为长期随访中视力恢复的潜在预测标志物。
