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.
Pituitary. 2022 Aug;25(4):667-672. doi: 10.1007/s11102-022-01248-6. Epub 2022 Jul 14.
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.
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.
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).
In patients who underwent resection of pituitary adenoma, nasal inferior GCIPL was an independent risk factor of visual field defect recover after surgery.
本研究旨在探讨光学相干断层扫描（OCT）测量的术前黄斑神经节细胞-内丛状层厚度（GCIPL）和视网膜神经纤维层厚度（RNFL）与垂体腺瘤患者术后视野（VF）缺损恢复之间的关系。
本病例对照研究纳入了 2019 年 10 月至 2021 年 6 月在山西省人民医院神经外科就诊的垂体腺瘤患者。所有患者均接受头颅 MRI 检查、三维 OCT 和 VF 检查（Humphrey Field Analyzer II750）。
共纳入 53 例垂体腺瘤患者（81 只眼），其中 15 例（23 只眼）为视野未恢复组（VFNR），38 例（58 只眼）为视野恢复组（VFR）。VFNR 组颞侧 RNFL（P = 0.002）和平均 RNFL（P = 0.009）明显低于 VFR 组。VFNR 组上方鼻侧 GCIPL（P = 0.001）、下方鼻侧 GCIPL（P = 0.001）和平均 GCIPL（P = 0.01）明显低于 VFR 组（均 P < 0.01）。多变量逻辑回归分析显示，鼻侧下方 GCIPL 是 VF 恢复的独立危险因素（比值比（OR） = 1.376，95%置信区间（CI）：1.089-1.739，P = 0.007）。在接受者操作特征（ROC）分析中，鼻侧下方 GCIPL 的 ROC 曲线下面积（AUROC）最高（AUROC = 0.739）。
在接受垂体腺瘤切除术的患者中，鼻侧下方 GCIPL 是术后视野缺损恢复的独立危险因素。
