Early Retinal Microcirculation Loss in Nonfunctioning Pituitary Adenomas Before Visual Field Defect by Wide-Field Swept Source Optical Coherence Tomography.

Background And Objectives: So far, little is known about early macular microcirculation changes in nonfunctioning pituitary adenomas (NFPA), particularly in patients before visual field defects (VFD) occur. The aim of our study was to evaluate the early retinal microcirculation alteration in NFPA before VFD by wide-field swept source optical coherence tomography (WF SS-OCTA).

Methods: A total of 64 NFPA patients without VFD and 64 healthy controls were included. The thickness of the retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), flow area (FA) and vessel density (VD) of radial capillary plexus (RCP), superficial vascular complex (SVC), and deep vascular complex (DVC) of their right eyes were measured on 12 mm × 12 mm macular area by WF SS-OCTA. The differences between the 2 groups were analyzed, and receiver operating characteristic curves were conducted to evaluate the diagnostic performance of retinal microcirculation.

Results: Compared with the controls, RCP VD, SVC FA, SVC VD, DVC FA, and DVC VD in NFPA were significantly lower ( P < .05). RCP FA, RNFL and GCC thicknesses were not significantly different between the 2 groups ( P > .05). Multiple regressions showed that RCP FA, RCP VD, SVC FA, and SVC VD were positively correlated with RNFL and GCC thicknesses ( P < .01), whereas DVC FA and DVC VD were associated with neither RNFL nor GCC thicknesses ( P > .05). The area under the receiver operating characteristic curve showed RCP VD, SVC VD, DVC FA, and DVC VD (area under the curve >0.6, P < .05) had diagnostic significances for NFPA.

Conclusion: NFPA patients before VFD produce a characteristic pattern of early retinal microcirculation loss that WF SS-OCTA can recognize. WF SS-OCTA is a useful tool for early predicting visual impairment in NFPA.