Retinal vasculature and pituitary adenomas: Quantitative analysis using optical coherence tomography angiography

Author: Rahma Saidane (Tunisia)

Co-authors: Racem Choura, Asma Khallouli, Dhouha Gouider, Ahmed Arfaoui, Afef Maalej, Riadh Rannen

Purpose

To assess the vasculature changes in the peripapillary and macular areas associated with pituitary adenomas (PA) using Optical Coherence Tomography Angiography (OCT-A).

Setting/Venue

Department of Ophthalmology of the Military Hospital of Tunis, Tunisia.

Methods

Prospective study was carried out between August 2020 and February 2021, including 20 eyes of 10 PA patients and 20 eyes of 10 healthy subjects. PA patients were divided into PA with optic neuropathy (12 eyes) and PA without optic neuropathy (8 eyes). Spectral domain (SD) OCTA 6 × 6 mm scans of the superficial (SCP) and deep capillary plexus (DCP) were analyzed in all eyes. A 4.5 × 4.5 mm images for the Radial Peripapillary Capillaries (RPC) were obtained. Peri-papillary Retinal Nerve Fiber Layer thickness (RNFL), whole image (wi), inside disc (id), peripapillary (pp) and macular vessel densities were evaluated in all eyes.

Results

Compared to healthy eyes, the RNFL was significantly thinner in the PA group (105.42± 2.61 and 92.12 ± 3.89 respectively, p<0.001). Whole image, id and ppVD in PA eyes were significantly lower compared to healthy eyes (p = 0.024). Adjusted to the presence of optic neuropathy, this difference remained significant between PA patients with optic neuropathy and healthy subjects (p=0.011), whereas there was no significant difference between PA patients without optic neuropathy and healthy subjects (p=0.062). Macular VDs in both plexuses were also significantly reduced in PA eyes (p=0,003). Pearson’s correlation coefficient showed a correlation between RPC VDs and RNFL thickness (r=0.76, p=0.019).

Conlusions

Vessel densities in PA eyes are significantly lower than in healthy eyes. A diminished microvascular network is associated with RNFL thinning. Retinal VDs changes can be used as biomarkers to evaluate the vision prognosis in long-term follow-up in PA eyes.

Financial Disclosure

The authors declare no conflict of interest