ECEESPE2025 Poster Presentations Pituitary, Neuroendocrinology and Puberty (162 abstracts)
Macular ganglion cell complex thickness and the post-illumination pupil response before and after chiasm decompression in pituitary adenoma patients with and without visual field loss
Tessel M. Boertien 1,2 , Esther M. Speksnijder 1 , Stanley Darma 3 , Frank D. Verbaak 3 , Jantien Hoogmoed 2,4 , Johannes C. Baaijen 2,4 , Eus J.W. van Someren 5,6,7 , Roekaya B. Djorai 1 , Phylomeen J.S. Puijk 1 , Linda Britsemmer 1 , M.L. Drent 2,8 , Eric Fliers 1,2 & Peter Bisschop 1,2
1Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Department of Endocrinology and Metabolism, Amsterdam, Netherlands; 2Pituitary Centre Amsterdam, Amsterdam, Netherlands; 3Amsterdam UMC, University of Amsterdam, Department of Ophthalmology, Amsterdam, Netherlands; 4Amsterdam UMC, University of Amsterdam, Department of Neurosurgery, Amsterdam, Netherlands; 5Netherlands Institute for Neuroscience (NIN), Department of Sleep and Cognition, Amsterdam, Netherlands; 6Amsterdam UMC, VU University, Department of Psychiatry, Amsterdam, Netherlands; 7VU University, Centre for Neurogenomics and Cognitive Research, Integrative Neurophysiology, Amsterdam, Netherlands; 8Amsterdam UMC, VU University, Amsterdam Gastroenterology Endocrinology Metabolism, Department of Endocrinology and Metabolism, Amsterdam, Netherlands
JOINT1195
Objective: Compression of retinal ganglion cell (RGC) axons in the optic chiasm of patients with pituitary adenoma can cause lasting visual impairment. It can also cause retrograde axonal degeneration, leading to significant thinning of the retinal macular ganglion cell complex (mGCC). Retinal thinning due to RGC damage may precede the detection of visual field defects (VFD). The aim of this study was to assess mGCC thickness and the post-illumination pupil response (PIPR) as indicators of structural and functional RGC health in patients with optic chiasm compression with and without VFD, and to determine the effect of transsphenoidal chiasm decompression.
Design: Prospective, observational study with preoperative and postoperative assessments in two predefined groups.
Methods: We studied 16 patients with a pituitary macroadenoma causing chiasm compression: eight with preoperative visual fields defects (VFD+ group) and eight without (VFD-group). Assessments took place preoperatively at baseline, and at 3 and past 12 months postoperatively. Retinal thickness was assessed with spectral domain optical coherence tomography (SD-OCT), and pupillometry was performed to determine the PIPR after blue light.
Results: At this time, we present preliminary data of the preoperative and first postoperative assessment at 3 months. Successful decompressive surgery was achieved in all but one patient. Preoperative mGCC thickness was significantly lower in the VFD+ group vs the VFD-group (nasal mGCC mean difference 40 µm, 95% CI 31–50 µm, P <0.001), and all measurements in VFD+ patients were below the minimum thickness measured in VFD- patients. Postoperative assessment showed stable retinal thickness in both groups, regardless of visual improvement. PIPR results were variable with no significant between-group or pre-postoperative within-group differences, although several patients in both groups showed a PIPR decrease after surgery.
Conclusion: Our preliminary results show that VFD are related to significant mGCC thinning, and that thinning persists 3 months after decompressive surgery, suggesting residual retinal damage. Based on the available evidence, implementation of SD-OCT in the standard diagnostic work-up of patients with optic chiasm compression has the potential to provide valuable information for preoperative counselling and planning of surgical intervention. The role of pupillometry and the PIPR requires further exploration. Comprehensive analysis of follow-up data is pending.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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