title: Predicting visual outcome after treatment of pituitary adenomas with optical coherence tomography.
abstract: OBJECTIVE
  To evaluate if optical coherence tomography (OCT), by providing an objective measure of the retinal nerve fiber layer (RNFL) thickness, offers a reliable prediction of visual outcome.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Thirty-seven eyes of 19 consecutive patients from a single hospital suffering from pituitary adenomas compressing the anterior visual pathways were included, and compared with 46 eyes of 23 controls. Exclusion criteria included any previous treatment of pituitary adenoma and high myopia. Seventeen patients underwent trans-sphenoidal surgery and two patients with macroprolactinomas received dopamine agonists. Automated visual fields (VF) and OCT (fast-RNFL program) were performed before treatment, and two weeks and three months after treatment.
  
  
  RESULTS
  Among the eyes with a VF defect before treatment, the odds of complete recovery after three months from the initial VF defect was multiplied by 1.29 for each increase by 1 micron of mean RNFL (odds ratio [OR], 1.29; P = .037). This was independent from age and duration of symptoms, which carried their own prognostic value. Inferior RNFL was a very strong prognostic factor; OR, 6.31 per micron (P = .0000).
  
  
  CONCLUSIONS
  RNFL thinning measured by OCT puts the patient at decreased chance of recovery of an initial VF defect three months after treatment in pituitary adenomas compressing the anterior visual pathways. Further studies will establish how useful this tool is for long-term visual outcome.
authors.affiliation: Université de Lyon, Lyon, France. maudjacob@gmail.com
authors.forename: Maud
authors.initials: M
authors.lastname: Jacob
authors.forename: Gérald
authors.initials: G
authors.lastname: Raverot
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Jouanneau
authors.forename: Françoise
authors.initials: F
authors.lastname: Borson-Chazot
authors.forename: Gilles
authors.initials: G
authors.lastname: Perrin
authors.forename: Muriel
authors.initials: M
authors.lastname: Rabilloud
authors.forename: Caroline
authors.initials: C
authors.lastname: Tilikete
authors.forename: Martine
authors.initials: M
authors.lastname: Bernard
authors.forename: Alain
authors.initials: A
authors.lastname: Vighetto
mesh_terms: D000236:Adenoma / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000503:physiopathology; D009412:Nerve Fibers / Q000473:pathology; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D015175:Prolactinoma / Q000188:drug therapy; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology; D041623:Tomography, Optical Coherence; D014794:Visual Fields / Q000502:physiology*; D014795:Visual Pathways / Q000503:physiopathology
chemical_list: D018491:Dopamine Agonists