Abstract
Purpose
The aim of this prospective study was to measure the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and the ganglion cell complex (GCC) using spectral domain optical coherence tomography (SD-OCT) in a cohort of consecutive de novo patients with pituitary macroadenomas without chiasmal compression.
Patients and methods
Twenty-two consecutive patients with pituitary macroadenoma without chiasmal compression (16 men, 6 women, aged 45.2±14.6 years, 43 eyes) entered the study between September 2011 and June 2013. Among them, 31.8% harboured a growth hormone-secreting pituitary adenoma, 27.3% a prolactin-secreting pituitary adenoma, 27.3% a corticotrophin-secreting pituitary adenoma, and 13.6% a non-secreting pituitary tumour. Eighteen subjects (nine females, nine males, mean age 36.47±6.37 years; 33 eyes) without pituitary adenoma, with normal ophthalmic examination, served as controls. In both patients and controls, cpRNFL and GCC thicknesses were measured by SD-OCT.
Results
Patients were significantly older (P=0.02) than controls. Best corrected visual acuity, intraocular pressure, colour fundus photography, and automatic perimetry test were within the normal range in patients and controls. Conversely, cpRNFL (P=0.009) and GCC (P<0.0001) were significantly thinner in patients than in controls. The average GCC (r=0.306, P=0.046) significantly correlated with the presence of arterial hypertension. OCT parameters did not differ significantly between patients with a tumour volume above the median and those with a tumour volume below the median.
Conclusion
Pituitary macroadenomas, even in the absence of chiasmal compression, may induce GCC and retinal nerve fibre layer thinning. SD-OCT may have a role in the early diagnosis and management of patients with pituitary tumours.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Melmed S, Kleinberg D . Anterior Pituitary. In: Melmed S, Polonsky KS, Reed Larsen P (eds). Williams Textbook of Endocrinology, 11th ed. Elsevier Health Sciences: Philadelphia, 2007.
Kovacs K, Horvath E . Pathology of pituitary tumors. Endocrinol Metab Clin North Am 1987; 16: 529–551.
Central Brain Tumor Registry of the United States 2007-2008. Central Brain Tumor Registry of the United States Statistical Report, 2008n 2006.
Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A . High prevalence of pituitary adenomas: a cross-sectional study in the province of Liège, Belgium. J Clin Endocrinol Metab 2006; 91: 4769–4775.
Colao A, Di Somma C, Pivonello R, Faggiano A, Lombardi G, Savastano S . Medicaltherapy for clinically non-functioningpituitaryadenomas. Endocr Relat Cancer 2008; 15 (4): 905–915.
Cappabianca P, Alfieri A, Colao A, Ferone D, Lombardi G, de Divitiis E . Endoscopic endonasaltranssphenoidal approach: an additional reason in support of surgery in the management of pituitary lesions. Skull Base Surg 1999; 9 (2): 109–117.
Colao A, Pivonello R, Auriemma RS, Briganti F, Galdiero M, Tortora F et al. Predictors of tumor shrinkage after primary therapy with somatostatin analogs in acromegaly: a prospective study in 99 patients. J Clin Endocrinol Metab 2006; 91 (6): 2112–2218.
Colao A, Di Sarno A, Cappabianca P, Briganti F, Pivonello R, Somma CD et al. Gender differences in the prevalence, clinical features and response to cabergoline in hyperprolactinemia. Eur J Endocrinol 2003; 148 (3): 325–331.
Pivonello R, Matrone C, Filippella M, Cavallo LM, Di Somma C, Cappabianca P et al. Dopamine receptor expression and function in clinically nonfunctioning pituitary tumors: comparison with the effectiveness of cabergoline treatment. J Clin Endocrinol Metab 2004; 89 (4): 1674–1683.
Colao A, Savastano S . Medical treatment of prolactinomas. Nat Rev Endocrinol 2011; 7 (5): 267–278.
Colao A, Di Sarno A, Landi ML, Cirillo S, Sarnacchiaro F, Facciolli G et al. Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage. J Clin Endocrinol Metab 1997; 82 (11): 3574–3579.
Zee CS, Go JL, Klim PE, Mitchell D, Ahmadi J . Imaging of the pituitary and parasellar region. Neurosurg Clin N Am 2003; 14: 55.
Monteiro ML, Leal BC, Rosa AA . Optical coherence analysis of axonal loss in band atrophy of optic nerve. Br J Ophthalmol 2004; 88: 896–899.
Leal BC, Moura FC, Monteiro ML . Retinal nerve fiber layer loss documented by Stratus OCT in patients with pituitary adenoma: case report. Arq Bras Oftalmol 2006; 69: 251–254.
Johansson C, Lindblom B . The role of optical coherence tomography in the detection of pituitary adenoma. Acta Ophthalmol 2009; 87: 776–779.
Jacob M, Raverot G, Jouanneau E, Borson-Chazot F, Perrin G, Rabilloud M et al. Predicting visual outcome after treatment of pituitary adenomas with optical coherence tomography. Am J Ophthalmol 2009; 147: 64–70.
Ventura LM, Venzara FX, Porciatti V . Reversible dysfunction of retinal ganglion cells in non-secreting pituitary tumors. Doc Ophthalmol 2009; 118: 155–162.
Moon CH, Hwang SC, Ohn YH, Park TK . The time course of visual field recovery and changes of retinal ganglion cells after optic chiasmal decompression. Invest Ophthalmol Vis Sci 2011; 52: 7966–7973.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, IzzoJr JL et alJoint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. Hypertension 2003; 42: 1206–1252.
World Health Organization Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO Consultation. Part. 1. Diagnosis and classification of diabetes mellitus. World Health Organization: Geneva, 1999.
Francoz M, Fenolland JR, Giraud JM, El Chehab H, Sendon D, May F et al. Reproducibility of macular ganglion cell– inner plexiform layer thickness measurement with cirrus HD-OCT in normal, hypertensive and glaucomatous eyes. Br J Ophthalmol 2014; 98: 322–328.
Cioffi GA . Ischemic model of optic nerve injury. Trans Am Ophthalmol Soc 2005; 103: 592–613.
Lange M, Pagotto U, Hopfner U, Ehrenreich H, Oeckler R, Sinowatz F et al. Endothelin expression in normal human anterior pituitaries and pituitary adenomas. J Clin Endocrinol Metab 1994; 79 (6): 1864–1870.
Ventura LM, Porciatti V . Restoration of retinal ganglion cell function in early glaucoma after intraocular pressure reduction: a pilot study. Ophthalmology 2005; 112: 20–27.
Pelletier EM, Shim B, Ben-Joseph R, Caro JJ . Economic outcomes asso-ciated with microvascular complications of type 2 diabetes mellitus: results from a US claims data analysis. Pharmacoeconomics 2009; 27: 479–490.
Alkuraya H, Kangave D, Abu El-Asrar AM . The correlation between coherence tomography features and severity of retinopathy, macular thickness and visual acuity in diabetic macular edema. Int Ophthalmol 2005; 26 (3): 93–99.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Cennamo, G., Auriemma, R., Cardone, D. et al. Evaluation of the retinal nerve fibre layer and ganglion cell complex thickness in pituitary macroadenomas without optic chiasmal compression. Eye 29, 797–802 (2015). https://doi.org/10.1038/eye.2015.35
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2015.35
This article is cited by
-
Retinal vascular and structural recovery analysis by optical coherence tomography angiography after endoscopic decompression in sellar/parasellar tumors
Scientific Reports (2023)
-
Symptoms at presentation in conservatively managed patients with non-functioning pituitary adenomas
Hormones (2023)
-
Optical coherence tomography and visual evoked potentials in evaluation of optic chiasm decompression
Scientific Reports (2022)
-
Predictive value of macular ganglion cell-inner plexiform layer thickness in visual field defect of pituitary adenoma patients: a case-control study
Pituitary (2022)
-
Assessment of inner retina layers thickness values in eyes with pituitary tumours before visual field defects occur
Eye (2021)