Department of Ophthalmology, Research Institute for Convergence of Biomediocal Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Ophthalmology, Biomedical Research Institute, School of Medicine, Pusan National University, Pusan National University Hospital, Busan, Korea.
PLoS One. 2024 Nov 12;19(11):e0313521. doi: 10.1371/journal.pone.0313521. eCollection 2024.
To investigate the factors affecting visual field recovery in patients with pituitary adenoma following surgical removal, both eyes of 35 patients with pituitary adenoma who had been followed up for > six months post-surgery were retrospectively analyzed.
Pre- and post-operative visual acuity, visual field test, retinal nerve fiber layer (RNFL), and ganglion cell inner plexiform layer (GCIPL) thickness were investigated. The average age of the 35 patients was 58.3 ± 11.5 years. Preoperatively, 30 eyes (mean average RNFL thickness, 99.73 ± 5.89 μm) and 40 eyes (mean average RNFL thickness, 77.55 ± 8.35 μm) were included in the thick (≥ 90 μm) and thin RNFL group (< 90 μm), respectively.
In the thick RNFL group, pre- and post-operative mean deviation (MD) and pattern standard deviation (PSD) were favorable (all p < 0.001), and the proportion of eyes of postoperative MD change which were stable or improved was greater than in the thin RNFL group (p = 0.042). Preoperative MD, RNFL (except nasal quadrant) and GCIPL thickness were positively correlated to postoperative MD values (all, p < 0.05). Preoperative MD and temporal RNFL thickness were significantly correlated with postoperative MD change rate (p = 0.03 and 0.04, respectively). Preoperative GC IPL thickness and postoperative MD change rate were not significantly correlated (p = 0.61). Using univariate regression analysis, preoperative best corrected visual acuity (Odds ratio [OR], 0.050; p < 0.001), tumor volume (OR, 1.110, p = 0.002), higher preoperative MD values (OR, 0.858; p < 0.001), lower preoperative PSD values (OR, 1.169, p = 0.002), thick RNFL (OR, 0.215; p = 0.003) and thick GCIPL (OR, 0.305, p = 0.018) were significantly associated with a good visual field outcome following surgery. According to multivariate analysis, any other parameters were not significant. In patients with thick RNFL, postoperative MD values were better than in the thin RNFL group.
Eyes with preoperative higher MD and thick temporal RNFL showed more improvement in their visual fields postoperative. Preoperative thick RNFL could be a potential predictor of visual field recovery following TSA-TR, while macular GCIPL thickness does not appear to be a reliable predictor.
探讨影响垂体腺瘤患者术后视野恢复的因素。对 35 例垂体腺瘤患者术后随访>6 个月的双眼进行回顾性分析。
术前、术后视力、视野检查、视网膜神经纤维层（RNFL）和节细胞内丛状层（GCIPL）厚度。35 例患者平均年龄 58.3±11.5 岁。术前 30 只眼（平均平均 RNFL 厚度 99.73±5.89μm）和 40 只眼（平均平均 RNFL 厚度 77.55±8.35μm）分别纳入厚（≥90μm）和薄 RNFL 组（<90μm）。
在厚 RNFL 组，术前和术后平均偏差（MD）和模式标准偏差（PSD）均良好（均 p<0.001），术后 MD 变化稳定或改善的眼比例大于薄 RNFL 组（p=0.042）。术前 MD、RNFL（除鼻象限外）和 GCIPL 厚度与术后 MD 值呈正相关（均 p<0.05）。术前 MD 和颞侧 RNFL 厚度与术后 MD 变化率显著相关（p=0.03 和 0.04）。术前 GC IPL 厚度与术后 MD 变化率无显著相关性（p=0.61）。使用单变量回归分析，术前最佳矫正视力（优势比[OR]，0.050；p<0.001）、肿瘤体积（OR，1.110，p=0.002）、较高的术前 MD 值（OR，0.858；p<0.001）、较低的术前 PSD 值（OR，1.169，p=0.002）、厚 RNFL（OR，0.215；p=0.003）和厚 GCIPL（OR，0.305，p=0.018）与术后良好的视野结果显著相关。根据多变量分析，任何其他参数均不显著。在厚 RNFL 患者中，术后 MD 值优于薄 RNFL 组。
术前 MD 值较高和颞侧厚 RNFL 的眼术后视野改善更明显。术前厚 RNFL 可能是 TSA-TR 后视野恢复的潜在预测因子，而黄斑 GCIPL 厚度似乎不是可靠的预测因子。
