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Aluyi-Osa G, Suleman A, Salati C, Spadea L, Gagliano C, Musa M, Zeppieri M. Multidisciplinary management of pituitary macroadenoma. World J Methodol 2025; 15:97694. [DOI: 10.5662/wjm.v15.i3.97694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 11/18/2024] [Accepted: 12/03/2024] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations. This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas, integrating neurosurgery, endocrinology, radiology, and pathology perspectives.
AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis, management, and rehabilitation of individuals with pituitary adenomas, to add to already preexisting knowledge, in managing these cases enhancing better ocular and systemic outcomes.
METHODS A search was conducted on an online publication database (PubMed) using the term “pituitary adenoma” including all results published over twenty years (2004-2024). Results were sorted for relevance, language, and completeness.
RESULTS A total of 176 records were returned. The guidelines of the PRISMA 2020 statement were followed in this study. A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates. Another 17 records were not available as full-length articles and were also excluded. The references of each included record was further searched for relevant publications. A total of 141 records were therefore used in this minireview.
CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact, modern therapeutic strategies offer effective management options. Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life. Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future
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Affiliation(s)
- Gladness Aluyi-Osa
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
| | - Ayuba Suleman
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna "Kore", Enna 94100, Italy
- Mediterranean Foundation "G.B. Morgagni", 95125 Catania, Italy
| | - Mutali Musa
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
- Department of Optometry, University of Benin, Benin 300283, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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Sarnat-Kucharczyk M, Pojda-Wilczek D, Mrukwa-Kominek E, Kos-Kudła B, Janik MA, Janik P. The Relationship Between the Ganglion Cell-Inner Plexiform Layer, Retinal Nerve Fiber Layer, and Photopic Negative Response in Newly Diagnosed Pituitary Macroadenoma: 12-Month Prospective Follow-Up Study. Cancers (Basel) 2025; 17:1542. [PMID: 40361469 PMCID: PMC12071830 DOI: 10.3390/cancers17091542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2025] [Revised: 04/27/2025] [Accepted: 04/28/2025] [Indexed: 05/15/2025] Open
Abstract
BACKGROUND/OBJECTIVES This prospective study evaluates the relationship between the ganglion cell-inner plexiform layer (GCIPL), retinal nerve fiber layer (RNFL), and photopic negative response (PhNR) in patients with newly diagnosed pituitary macroadenomas over 12 months. METHODS A total of 40 patients (80 eyes) were included, divided into a treatment group of 27 patients (54 eyes), receiving pharmacological and/or surgical intervention, and an observation group of 13 patients (26 eyes), with non-functional pituitary adenomas (NFPAs) that did not require treatment. RESULTS Key findings indicate a significant improvement in best corrected visual acuity (BCVA) after 12 months in the treatment group (p = 0.02) and a significant reduction in RNFL thickness in multiple quadrants (p < 0.01). Moreover, PhNR amplitude and W-ratio significantly increased in the treatment group (p < 0.0001). In the observation group, only GCIPL Inferior (p = 0.0470) and PhNR W-ratio (p = 0.0015) showed significant differences. Between-group comparisons showed significant differences in RNFL Nasal quadrant at baseline (p = 0.0017) and after 12 months (p = 0.0150). PhNR amplitude and W-ratio also differed significantly between groups at 12 months (p = 0.0012 and p = 0.0016, respectively). Correlations between OCT and ERG parameters were weak at baseline and diminished over time. CONCLUSIONS These findings suggest that GCIPL, RNFL, and PhNR analyses may be useful for monitoring disease progression and guiding treatment decisions in patients with pituitary macroadenomas.
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Affiliation(s)
- Monika Sarnat-Kucharczyk
- Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (D.P.-W.); (E.M.-K.)
- Kornel Gibinski University Clinical Centre, 40-514 Katowice, Poland;
| | - Dorota Pojda-Wilczek
- Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (D.P.-W.); (E.M.-K.)
- Kornel Gibinski University Clinical Centre, 40-514 Katowice, Poland;
| | - Ewa Mrukwa-Kominek
- Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (D.P.-W.); (E.M.-K.)
- Kornel Gibinski University Clinical Centre, 40-514 Katowice, Poland;
| | - Beata Kos-Kudła
- Kornel Gibinski University Clinical Centre, 40-514 Katowice, Poland;
- Department of Endocrinology and Neuroendocrine Tumors, Medical University of Silesia, 40-514 Katowice, Poland
| | - Małgorzata A. Janik
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, 41-205 Sosnowiec, Poland; (M.A.J.); (P.J.)
| | - Paweł Janik
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, 41-205 Sosnowiec, Poland; (M.A.J.); (P.J.)
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Tan Z, Lu KL, Zhang WC, Peng SY, Wen XJ, Dai TT, Pang YH. Comparative of OCT and OCTA parameters in patients with early chronic angle-closure glaucoma and early pituitary adenoma. Sci Rep 2024; 14:21448. [PMID: 39271729 PMCID: PMC11399151 DOI: 10.1038/s41598-024-71103-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 08/26/2024] [Indexed: 09/15/2024] Open
Abstract
Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) have the potential application in evaluating pathological structural change of the optic nerve. We aimed to evaluate the value of the OCT and OCTA parameters of the optic disk and macular in differentiating early chronic primary angle-closure glaucoma (CPACG) and early pituitary adenoma (PA) in case of mild visual field defects (the mean defect (MD) > 6 dB). The results showed that regarding OCTA parameters, CPACG patients had lower retinal blood flow density of most layers of the optic disk and macular than PA patients. Regarding OCT parameters, CPACG patients had thinner circumpapillary retinal nerve fiber layer (CP-RNFL) in all quadrants and average CP-RNFL, ganglion cell layer (GCL) and macular ganglion cell complex (GCC) in each quadrant of macular inner and outer rings, and inner plexus layer (IPL) of macular inner ring, superior-outer ring and temporal-outer ring than PA patients. The Z test indicated that OCTA parameters and OCT parameters had similar value in the diagnosis of disease. In conclusion, in the case of similar visual field damage, early CPACG patients have smaller blood flow density and thinner optic disk and macular than early PA. OCTA has similar performance to OCT in diagnosing CPACG and PA.
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Affiliation(s)
- Zhi Tan
- Radiology Department. Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Kai-Lun Lu
- Ophthalmology Department Affiliated Hospital of Guangdong Medical University, No. 57, South Renmin Avenue, Xiashan District, Zhanjiang, 524023, Guangdong Province, China
| | - Wan-Cheng Zhang
- Ophthalmology Department Affiliated Hospital of Guangdong Medical University, No. 57, South Renmin Avenue, Xiashan District, Zhanjiang, 524023, Guangdong Province, China
| | - Shu-Ying Peng
- Radiology Department. Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Xiu-Juan Wen
- Ophthalmology Department Affiliated Hospital of Guangdong Medical University, No. 57, South Renmin Avenue, Xiashan District, Zhanjiang, 524023, Guangdong Province, China
| | - Tong-Tong Dai
- Ophthalmology Department Affiliated Hospital of Guangdong Medical University, No. 57, South Renmin Avenue, Xiashan District, Zhanjiang, 524023, Guangdong Province, China
| | - Yan-Hua Pang
- Ophthalmology Department Affiliated Hospital of Guangdong Medical University, No. 57, South Renmin Avenue, Xiashan District, Zhanjiang, 524023, Guangdong Province, China.
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Kleerekooper I, Wagner SK, Trip SA, Plant GT, Petzold A, Keane PA, Khawaja AP. Differentiating glaucoma from chiasmal compression using optical coherence tomography: the macular naso-temporal ratio. Br J Ophthalmol 2024; 108:695-701. [PMID: 37385651 PMCID: PMC11137440 DOI: 10.1136/bjo-2023-323529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/06/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND/AIMS The analysis of visual field loss patterns is clinically useful to guide differential diagnosis of visual pathway pathology. This study investigates whether a novel index of macular atrophy patterns can discriminate between chiasmal compression and glaucoma. METHODS A retrospective series of patients with preoperative chiasmal compression, primary open-angle glaucoma (POAG) and healthy controls. Macular optical coherence tomography (OCT) images were analysed for the macular ganglion cell and inner plexiform layer (mGCIPL) thickness. The nasal hemi-macula was compared with the temporal hemi-macula to derive the macular naso-temporal ratio (mNTR). Differences between groups and diagnostic accuracy were explored with multivariable linear regression and the area under the receiver operating characteristic curve (AUC). RESULTS We included 111 individuals (31 with chiasmal compression, 30 with POAG and 50 healthy controls). Compared with healthy controls, the mNTR was significantly greater in POAG cases (β=0.07, 95% CI 0.03 to 0.11, p=0.001) and lower in chiasmal compression cases (β=-0.12, 95% CI -0.16 to -0.09, p<0.001), even though overall mGCIPL thickness did not discriminate between these pathologies (p=0.36). The mNTR distinguished POAG from chiasmal compression with an AUC of 95.3% (95% CI 90% to 100%). The AUCs when comparing healthy controls to POAG and chiasmal compression were 79.0% (95% CI 68% to 90%) and 89.0% (95% CI 80% to 98%), respectively. CONCLUSIONS The mNTR can distinguish between chiasmal compression and POAG with high discrimination. This ratio may provide utility over-and-above previously reported sectoral thinning metrics. Incorporation of mNTR into the output of OCT instruments may aid earlier diagnosis of chiasmal compression.
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Affiliation(s)
- Iris Kleerekooper
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Dutch Expertise Centre for Neuro-ophthalmology & MS Centre, Departments of Neurology and Ophthalmology, Amsterdam UMC, Amsterdam, Netherlands
| | - Siegfried K Wagner
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - S Anand Trip
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
- University College London Hospitals (UCLH) NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Gordon T Plant
- Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
| | - Axel Petzold
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Dutch Expertise Centre for Neuro-ophthalmology & MS Centre, Departments of Neurology and Ophthalmology, Amsterdam UMC, Amsterdam, Netherlands
| | - Pearse A Keane
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Anthony P Khawaja
- Institute of Ophthalmology, University College London, London, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Buist G, Debiasi M, Amelink A, de Boer JF. Theoretical and experimental determination of the confocal function of OCT systems for accurate calculation of sample optical properties. BIOMEDICAL OPTICS EXPRESS 2024; 15:2937-2957. [PMID: 38855667 PMCID: PMC11161342 DOI: 10.1364/boe.516229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/25/2024] [Accepted: 03/30/2024] [Indexed: 06/11/2024]
Abstract
The attenuation coefficient of biological tissue could serve as an indicator of structural and functional changes related to the onset or progression of disease. Optical coherence tomography (OCT) provides cross sectional images of tissue up to a depth of a few millimeters, based on the local backscatter properties. The OCT intensity also depends on the confocal function, which needs to be characterised to determine correctly the exponential decay of the intensity based on Lambert-Beer. We present a model for the confocal function in scattering media based on the illumination with a Gaussian beam and the power transfer into a single mode fibre (SMF) of the backscattered light for an incoherently back scattered Gaussian beam using the Huygens-Fresnel principle and compare that model with the reflection from a mirror. We find that, contrary to previous literature, the confocal functions characterised by the Rayleigh range in the two models are identical. Extensive OCT focus series measurements on a mirror, Spectralon and Intralipid dilutions confirm our model, and show that for highly scattering samples the confocal function characterised by the Rayleigh range becomes depth dependent. From the diluted Intralipid measurements the attenuation coefficients are extracted using a singly scatter model that includes the previously established confocal function. The extracted attenuation coefficients were in good agreement for weakly scattering samples (μ s < 2 mm-1).
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Affiliation(s)
- Gijs Buist
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maddalena Debiasi
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
| | - Arjen Amelink
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Optics, Netherlands Organisation for Applied Scientific Research, TNO, Delft, The Netherlands
| | - Johannes F. de Boer
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
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Singha S, Beniwal M, Mailankody P, Battu R, Saini J, Tyagi G, Srinivas D. Role of Optical Coherence Tomography in Predicting Visual Outcome after Surgery for Sellar and Supra-Sellar Tumors. Neurol India 2024; 72:50-57. [PMID: 38443001 DOI: 10.4103/neurol-india.neurol-india-d-23-00654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/06/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Almost one-fifth of patients undergoing surgery for sellar/supra-sellar tumors do not gain a significant improvement in their vision. Various methods have been described to predict prospective visual outcomes in them, although they lack uniformity. OBJECTIVE The study was conducted to predict visual outcomes following surgery for sellar and supra-sellar tumors compressing the anterior optic pathway based on pre-operative optical coherence tomography (OCT) parameters. METHODS AND MATERIALS This was a record-based observational descriptive longitudinal study done in a tertiary care center in India. Thirty-seven patients (74 eyes) diagnosed with sellar supra-sellar lesions were included in the study. Patients' ophthalmic evaluations, done pre-operatively and 3 months post-operatively, were reviewed. Spectral-domain OCT and segmentation were done using the automated segmentation technology of Spectralis software. The thickness of the respective layers was measured. RESULTS AND CONCLUSIONS The mean age of the study population was 42.68 years. Eyes with a pre-operative visual acuity component of VIS (visual impairment score) ≤61, pre-operative ganglion cell layer thickness ≥26.31 um, a pre-operative inner plexiform layer thickness of ≥25.69 um, a pre-operative ganglion cell inner plexiform layer thickness of 52.00 um, pre-operative ganglion cell complex thickness ≥84.47 μm, and a pre-operative inner retinal layer thickness of ≥205.25 μm were more likely to have an improved visual outcome. Eyes with a pre-operative duration of visual symptoms of ≥15 months, VIS ≥126.50, a pre-operative decimal visual acuity of <0.035, a pre-operative visual field index of ≤8%, a pre-operative macular thickness of ≤287.06 um, a pre-operative macular RNFL (retinal nerve fiber layer) thickness ≤66.00 μm, and a pre-operative peri-papillary RNFL thickness ≤64.62 μm were unlikely to have visual improvement.
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Affiliation(s)
- Souvik Singha
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Manish Beniwal
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pooja Mailankody
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Rajani Battu
- Department of Ophthalmology, Aster CMI Hospital, Bengaluru, Karnataka, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology (NIIR), National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gaurav Tyagi
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Xu C, Chen Z, Zhang X, Peng Y, Tan Z, Fan Y, Liao X, Chen H, Shen J, Chen X. Accurate C/D ratio estimation with elliptical fitting for OCT image based on joint segmentation and detection network. Comput Biol Med 2023; 160:106903. [PMID: 37146494 DOI: 10.1016/j.compbiomed.2023.106903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/12/2023] [Accepted: 04/09/2023] [Indexed: 05/07/2023]
Abstract
Proper estimation of the cup-to-disc ratio (C/D ratio) plays a significant role in ophthalmic examinations, and it is urgent to improve the efficiency of C/D ratio automatic measurement. Therefore, we propose a new method for measuring the C/D ratio of OCTs in normal subjects. Firstly, the end-to-end deep convolution network is used to segment and detect the inner limiting membrane (ILM) and the two Bruch's membrane opening (BMO) terminations. Then, we introduce an ellipse fitting technique to post-process the edge of the optic disc. Finally, the proposed method is evaluated on 41 normal subjects using the optic-disc-area scanning mode of three machines: BV1000, Topcon 3D OCT-1, and Nidek ARK-1. In addition, pairwise correlation analyses are carried out to compare the C/D ratio measurement method of BV1000 to existing commercial OCT machines as well as other state-of-the-art methods. The correlation coefficient between the C/D ratio calculated by BV1000 and the C/D ratio calculated by manual annotation is 0.84, which indicates that the proposed method has a strong correlation with the results of manual annotation by ophthalmologists. Moreover, in comparison between BV1000, Topcon and Nidek in practical screening among normal subjects, the proportion of the C/D ratio less than 0.6 calculated by BV1000 accounts for 96.34%, which is the closest to the clinical statistics among the three OCT machines. The above experimental results and analysis show that the proposed method performs well in cup and disc detection and C/D ratio measurement, and compared with the existing commercial OCT equipment, the C/D ratio measurement results are relatively close to reality, which has certain clinical application value.
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Affiliation(s)
- Chenan Xu
- State Key Laboratory of Radiation Medicine and Protection, Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, and School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, 215006, China
| | - Zhongyue Chen
- School of Electronics and Information Engineering and Medical Image Processing, Analysis and Visualization Lab, Soochow University, Suzhou, Jiangsu Province, 215006, China
| | - Xiao Zhang
- School of Electronics and Information Engineering and Medical Image Processing, Analysis and Visualization Lab, Soochow University, Suzhou, Jiangsu Province, 215006, China
| | - Yuanyuan Peng
- School of Electronics and Information Engineering and Medical Image Processing, Analysis and Visualization Lab, Soochow University, Suzhou, Jiangsu Province, 215006, China
| | - Zhiwei Tan
- School of Electronics and Information Engineering and Medical Image Processing, Analysis and Visualization Lab, Soochow University, Suzhou, Jiangsu Province, 215006, China
| | - Yu Fan
- Bigvision Medical Technology Co., Ltd., Suzhou, Jiangsu Province, 215006, China
| | - Xulong Liao
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong Province, 515041, China
| | - Haoyu Chen
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong Province, 515041, China
| | - Jiayan Shen
- School of Electronics and Information Engineering and Medical Image Processing, Analysis and Visualization Lab, Soochow University, Suzhou, Jiangsu Province, 215006, China
| | - Xinjian Chen
- State Key Laboratory of Radiation Medicine and Protection, Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, and School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, 215006, China; School of Electronics and Information Engineering and Medical Image Processing, Analysis and Visualization Lab, Soochow University, Suzhou, Jiangsu Province, 215006, China.
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Pang Y, Tan Z, Chen X, Liao Z, Yang X, Zhong Q, Huang B, Zhong Q, Zhong J, Mo W. Evaluation of preoperative visual pathway impairment in patients with non-functioning pituitary adenoma using diffusion tensor imaging coupled with optical coherence tomography. Front Neurosci 2023; 17:1057781. [PMID: 36845438 PMCID: PMC9947395 DOI: 10.3389/fnins.2023.1057781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023] Open
Abstract
Objective Optic chiasma compression and associated visual impairment induced by a non-functioning pituitary adenoma (NFPA) is commonly assessed by the optic disk and retina but is inadequate to understand the entire visual pathway impairment. We aim to evaluate the use of optical coherence tomography (OCT) coupled with diffusion tensor imaging (DTI) for the preoperative evaluation of visual pathway impairment. Methods Fifty-three patients with NFPA (categorized into mild and heavy compression subgroups) were subjected to OCT to calculate the thickness of the circumpapillary retinal nerve fiber layer (CP-RNFL), macular ganglion cell complex (GCC), macular ganglion cell layer (GCL), and macular inner plexus layer (IPL), as well as to DTI to calculate the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values. Results Compared to mild compression, heavy compression caused decreased FA value, increased ADC value of several segments of the visual pathway, thin temporal CP-RNFL, and quadrant macular GCC, IPL, and GCL. Average CP-RNFL thickness, inferior-macular inner-ring IPL and GCC thicknesses, inferior CP-RNFL thickness, and superior CP-RNFL thickness were the best indicators of the impairment of the optic nerve, optic chiasma, optic tract, and optic radiation, respectively. Conclusion DTI and OCT parameters can effectively evaluate visual pathway impairment and are beneficial for the objective preoperative evaluation of visual pathway impairment in patients with NFPA.
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Affiliation(s)
- Yanhua Pang
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Zhi Tan
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Xinxin Chen
- Teaching and Research Center of Medical Communication Science, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Zhihui Liao
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Xin Yang
- Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Qin Zhong
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Baqi Huang
- Department of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Qianshuo Zhong
- Department of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jingxiang Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China,Department of Ophthalmology, The Sixth Affiliated Hospital of Jinan University, Guangzhou, China,*Correspondence: Jingxiang Zhong,
| | - Wei Mo
- Department of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China,Wei Mo,
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Menon S, Nair S, Kodnani A, Hegde A, Nayak R, Menon G. Retinal nerve fiber layer thickness and its correlation with visual symptoms and radiological features in pituitary macroadenoma. J Neurosci Rural Pract 2023; 14:41-47. [PMID: 36891116 PMCID: PMC9943945 DOI: 10.25259/jnrp_18_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of the study was to evaluate the association of the thickness of retinal nerve fiber layer (RNFL) with (i) visual symptoms and (ii) suprasellar extension defined by magnetic resonance imaging (MRI) in patients with pituitary macroadenoma. Materials and Methods RNFL thickness of 50 consecutive patients operated for pituitary macroadenoma between July 2019 and April 2021 were compared with standard visual examination findings and MRI measurements such as optic chiasm height, distance between the optic chiasm and adenoma, suprasellar extension, and chiasmal lift. Results The study group included 100 eyes of 50 patients operated for pituitary adenomas with suprasellar extension. RNFL thinning predominantly involved the nasal (84.26 ± 16.43 μm) and temporal quadrants (70.72 ± 14.80 μm) and correlated well with the visual field deficit (P < 0.001). Patients with moderate-to-severe deficit in visual acuity had a mean RNFL thickness <85 μm and patients with severe disc pallor had extremely thin RNFLs (<70 μm). Suprasellar extension defined as Wilsons Grade C, D, and E and Fujimotos Grades 3 and 4 were significantly associated with thin RNFLs <85 μm (P < 0.01). Chiasmal lift more than 1 cm and tumor chiasm distance of <0.5 mm were associated with thin RNFL (P < 0.002). Conclusion RNFL thinning correlates directly with the severity of visual deficits in patients with pituitary adenoma. Wilsons Grade D and E, Fujimoto Grade 3 and 4, chiasmal lift more than 1 cm, and chiasm tumor distance <0.5 mm are strong predictors of RNFL thinning and poor vision. Pituitary macro adenoma and other suprasellar tumors need to be excluded in patients with preserved vision but having obvious RNFL thinning.
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Affiliation(s)
- Sudha Menon
- Department of Ophthalmology, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India
| | - Soumya Nair
- Department of Ophthalmology, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India
| | - Anuj Kodnani
- Department of Ophthalmology, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India
| | - Ajay Hegde
- Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India
| | - Raghavendra Nayak
- Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India
| | - Girish Menon
- Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India
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Jeong SS, Funari A, Agarwal V. Diagnostic and Prognostic Utility of Optical Coherence Tomography in Patients with Sellar/Suprasellar Lesions with Chiasm Impingement: A Systematic Review/ Meta-Analyses. World Neurosurg 2022; 162:163-176.e2. [PMID: 35276393 DOI: 10.1016/j.wneu.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND In this review, we appraised the current literature on the utility of optical coherence tomography (OCT) as a diagnostic and predictive factor for postoperative visual function outcomes in patients with sellar/suprasellar lesions with chiasmal impingement. METHODS A systematic search of PubMed, CINAHL, Scopus, and Cochrane Library was conducted following PRISMA guidelines. Included studies described diagnostic or prognostic utility of OCT in patients with sellar/suprasellar lesions with chiasmal impingement. Meta-analysis was represented with mean difference (MD) with 95% confidence intervals. Meta-regression was performed to determine predictive factors of visual outcomes. RESULTS Forty-eight articles were identified for final pooled analysis, representing a total of 2,435 patients with compressive sellar/suprasellar lesions and 952 healthy controls. Mean age was 43.3(11.4) years, with 1,494(48.8%) male and 1,566(51.2%) female patients. Mean retinal nerve fiber layer(RNFL) was significantly different in the study population compared to healthy controls(75.8μ[13.2] vs 91.4μ[10.8], p<0.00001). The nasal segment of RNFL had the largest mean difference (MD -9.76[-12.39, -7.13], p<0.0001). Visual acuity, visual field mean deviation (VF-MD), and visual field pattern standard deviation, all showed significant differences between the study population and healthy controls as well(p<0.0001). Meta-regressions showed significant predictive capability of preoperative RNFL in determining visual function outcome (p<0.05). CONCLUSION Our findings provide promising support for the growing evidence that OCT parameters can be utilized as both a diagnostic and prognostic tool for patients with compression of the optic apparatus. There is a need for further studies to gain a better understanding of OCTs and to improve patient outcomes.
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Affiliation(s)
- Seth S Jeong
- Albert Einstein College of Medicine, Bronx, New York, USA; Department of Otolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA.
| | - Abigail Funari
- Albert Einstein College of Medicine, Bronx, New York, USA; Department of Neurological Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Vijay Agarwal
- Albert Einstein College of Medicine, Bronx, New York, USA; Department of Neurological Surgery, Montefiore Medical Center, Bronx, New York, USA; Department of Otolaryngology, Montefiore Medical Center, Bronx, New York, USA
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11
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Kübler J, Zoutenbier VS, Amelink A, Fischer J, de Boer JF. Investigation of methods to extract confocal function parameters for the depth resolved determination of attenuation coefficients using OCT in intralipid samples, titanium oxide phantoms, and in vivo human retinas. BIOMEDICAL OPTICS EXPRESS 2021; 12:6814-6830. [PMID: 34858682 PMCID: PMC8606142 DOI: 10.1364/boe.440574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 05/18/2023]
Abstract
The attenuation coefficient provides a quantitative parameter for tissue characterization and can be calculated from optical coherence tomography (OCT) data, but accurate determination requires compensation for the confocal function. We present extensive measurement series for extraction of the focal plane and the apparent Rayleigh length from the ratios of OCT images acquired with different focus depths and compare these results with two alternative approaches. By acquiring OCT images for a range of different focus depths the optimal focus plane difference is determined for intralipid and titanium oxide (TiO2) phantoms with different scatterer concentrations, which allows for calculation of the attenuation coefficient corrected for the confocal function. The attenuation coefficient is determined for homogeneous intralipid and TiO2 samples over a wide range of concentrations. We further demonstrate very good reproducibility of the determined attenuation coefficient of layers with identical scatter concentrations in a multi-layered phantom. Finally, this method is applied to in vivo retinal data.
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Affiliation(s)
- Johannes Kübler
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
- Heidelberg Engineering GmbH, Heidelberg, Germany
| | - Vincent S. Zoutenbier
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
| | - Arjen Amelink
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Optics, Netherlands Organization for Applied Scientific Research, TNO, Delft, The Netherlands
| | - Jörg Fischer
- Heidelberg Engineering GmbH, Heidelberg, Germany
| | - Johannes F. de Boer
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, The Netherlands
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12
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Agarwal R, Jain VK, Singh S, Charlotte A, Kanaujia V, Mishra P, Sharma K. Segmented retinal analysis in pituitary adenoma with chiasmal compression: A prospective comparative study. Indian J Ophthalmol 2021; 69:2378-2384. [PMID: 34427226 PMCID: PMC8544063 DOI: 10.4103/ijo.ijo_2086_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose: The aim of this study was to determine the alteration in ganglion cell complex and its relationship with retinal nerve fiber layer (RNFL) thickness as measured by spectral-domain optical coherence tomography (OCT) in pituitary adenoma cases and also its correlation with visual field (VF). Methods: This is a prospective comparative study wherein detailed neuro-ophthalmic examination including perimetry, RNFL and ganglion cell layer inner plexiform layer (GCL-IPL) thickness were measured preoperatively in the cases of pituitary adenoma with chiasmal compression with visual symptoms and field changes who were planned for neuro-surgical intervention. These parameters were repeated 1 year after the surgery. GCL-IPL, RNFL parameters were compared with controls and were correlated with VF mean deviation (MD). The diagnostic power of GCL-IPL was tested using the receiver operating characteristic (ROC) curve. Healthy age and sex-matched controls without any ocular and systemic abnormality were taken for comparison. Results: Twenty-four patients qualified the inclusion criteria. A significant thinning of GCL-IPL (P = 0.002) and RNFL (P = 0.039) was noticed in the pituitary adenoma group. GCL-IPL (r = 0.780 P < 0.001) and RNFL (r = 0.669, P < 0.001) were significantly correlated with the MD. The ROC curve values of GCL-IPL were 0.859 (95% confidence interval 0.744% to 0.973) and of RNFL were 0.731 (95% confidence interval 0.585–0.877). The diagnostic ability of GCL-IPL was more as compared to the RNFL analysis, although it was statistically insignificant (P = 0.122). Conclusion: GCL-IPL measurements on the OCT are a sensitive tool to detect early anterior visual pathway changes in chiasmal compression for pituitary adenoma patients.
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Affiliation(s)
- Rachna Agarwal
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vaibhav K Jain
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shalini Singh
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Akshata Charlotte
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vikas Kanaujia
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Prabhakar Mishra
- Department of Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kumudini Sharma
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Minakaran N, de Carvalho ER, Petzold A, Wong SH. Optical coherence tomography (OCT) in neuro-ophthalmology. Eye (Lond) 2021; 35:17-32. [PMID: 33239763 PMCID: PMC7852683 DOI: 10.1038/s41433-020-01288-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 01/01/2023] Open
Abstract
Optical coherence tomography (OCT) is a non-invasive medical imaging technology that is playing an increasing role in the routine assessment and management of patients with neuro-ophthalmic conditions. Its ability to characterise the optic nerve head, peripapillary retinal nerve fibre layer and cellular layers of the macula including the ganglion cell layer enables qualitative and quantitative assessment of optic nerve disease. In this review, we discuss technical features of OCT and OCT-based imaging techniques in the neuro-ophthalmic context, potential pitfalls to be aware of, and specific applications in more common neuro-ophthalmic conditions including demyelinating, inflammatory, ischaemic and compressive optic neuropathies, optic disc drusen and raised intracranial pressure. We also review emerging applications of OCT angiography within neuro-ophthalmology.
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Affiliation(s)
- Neda Minakaran
- Moorfields Eye Hospital NHS Foundation Trust, London, UK.
| | - Emanuel R de Carvalho
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Department of Ophthalmology, University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Axel Petzold
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Neuro-ophthalmology Expertise Centre, University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- UCL Institute of Neurology, Queen Square, London, UK
| | - Sui H Wong
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Guys and St Thomas' NHS Foundation Trust, London, UK
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14
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Chou Y, Zhang B, Gan L, Ma J, Zhong Y. Clinical efficacy of optical coherence tomography in sellar mass lesions: a meta-analysis. Pituitary 2020; 23:733-744. [PMID: 32767247 DOI: 10.1007/s11102-020-01072-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Although optical coherence tomography (OCT) of the eyes has been studied to detect and monitor sellar masses, there is no recommendation for selecting the most effective measurement of OCT in clinical practice. Thus, we conducted a meta-analysis to examine the efficacy of OCT in sellar mass lesions. METHODS We conducted a literature search in PubMed and EMBASE through April 26, 2020. The primary outcomes were the thickness of the peripapillary retinal nerve fiber layer (pRNFL) and the macular ganglion cell complex (mGCC). The secondary outcomes included the thickness of the macular ganglion cell and inner plexiform layer (mGCIPL) and macular thickness. Random-effects models were used in all meta-analyses. Additionally, we conducted meta-regressions and subgroup analyses. RESULTS We included 22 studies, involving 1347 eyes of patients and 1198 eyes of controls. When compared with the control group, the reductions in pRNFL, mGCC and macular thickness in the patient group were significantly different, whereas significant thinning of the mGCIPL was restricted to the nasal hemiretina. Furthermore, we found that before visual field (VF) defects occurred, significant thinning of the pRNFL and mGCC thickness could be detected by OCT. The change in OCT parameters also showed different patterns in different types of pituitary adenomas. CONCLUSIONS Sellar mass lesions were associated with the changes in OCT measurements. The characteristic patterns of the OCT parameters may refine the diagnostic accuracy. Moreover, the alterations of OCT metrics before VF defects indicate the efficacy of OCT in early detection. Different types of pituitary adenomas may vary in OCT measurements, and their specific features warrant further research efforts.
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Affiliation(s)
- Yuyu Chou
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Bilei Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Linyang Gan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jin Ma
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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15
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Quantitative Analysis of Macular Retina Using Light Reflection Indices Derived from SD-OCT for Pituitary Adenoma. J Ophthalmol 2020; 2020:8896114. [PMID: 33204524 PMCID: PMC7658689 DOI: 10.1155/2020/8896114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose To quantitatively investigate the macular retinal light reflection characteristic using optical property indices derived from spectral-domain optical coherence tomography (SD-OCT) scans with depth attenuation compensation for pituitary adenoma. Methods This study included 38 patients (mean age 44.66 ± 13.77 years old) with diagnosis of pituitary adenoma and 43 age-matched controls. All SD-OCT scans were light attenuation compensated by a depth-resolved model. Attenuation coefficient, the corrected intensity, and the retinal layer thickness were deduced for macular retinal nerve fiber layer (RNFL) and ganglion cell layer combined with inner plexiform layer (GCIPL), as well as comparing between patients and controls by statistical methods. Results Attenuation coefficients of RNFL and GCIPL among patients were significantly lower compared to the controls with P values equal to or less than 0.001. The mean values of the corrected optical intensity were decreased in the patients without universally significant differences. Significant decreases in thickness existing in the RNFL of patients, especially in the superonasal (SN) quadrant and inferonasal (IN) quadrant (decrease ratio = 9.64% and 13.02%, both with P < 0.001). The thickness of RNFL was significantly associated with the attenuation coefficient (standardized beta = 0.335, P=0.002). The performances of attenuation coefficient were better than the corrected optical intensity and the thickness (the values of the areas under the receiver operating characteristic curves = 0.751 and 0.758, both with P < 0.001) in discriminating pituitary adenoma patients from controls. Conclusions The retinal light reflection characteristics were debilitated in patients with pituitary adenoma. The potential of attenuation coefficients of RNFL and GCIPL in distinguishing patients with pituitary adenoma from controls was validated by the comparison of the derived optical property indices.
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16
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Risseeuw S, Bennink E, Poirot MG, de Jong PA, Spiering W, Imhof SM, van Leeuwen R, Ossewaarde-van Norel J. A Reflectivity Measure to Quantify Bruch's Membrane Calcification in Patients with Pseudoxanthoma Elasticum Using Optical Coherence Tomography. Transl Vis Sci Technol 2020; 9:34. [PMID: 32855880 PMCID: PMC7422762 DOI: 10.1167/tvst.9.8.34] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose Progressive calcification of Bruch's membrane (BM) causes considerable visual morbidity in patients with pseudoxanthoma elasticum (PXE). Since calcification is hyperreflective on optical coherence tomography (OCT), our aim was to measure BM calcification with OCT imaging. Methods Case-control study with 45 patients with PXE under 40 years (range, 11-39) and 25 controls (range, 14-39). Spectralis HRA-OCT imaging consisted of seven macular B-scans with 250-µm spacing. Retinal segmentation was performed with the IOWA Reference Algorithms. MATLAB was used to extract and average z-axis reflectivity profiles. Layer reflectivities were normalized to the ganglion cell and inner plexiform layers. Both median and peak layer reflectivities were compared between patients with PXE and controls. The discriminative value of the retinal pigment epithelium (RPE)-BM peak reflectivity was analyzed using receiver operating characteristic analysis. Results The reflectivity profile of patients with PXE differed from controls in the outer retinal layers. The normalized median RPE-BM reflectivity was 41.1 (interquartile range [IQR], 26.3-51.9) in patients with PXE, compared with 22.5 (IQR, 19.3-29.5) in controls (P = 2.09 × 10-3). The normalized RPE-BM peak reflectivity was higher in patients with PXE (67.5; IQR, 42.1-84.2) than in controls (32.7; IQR, 25.7-38.9; P = 2.43 × 10-5) and had a high discriminative value with an area under the curve of 0.85 (95% confidence interval, 0.76-0.95). In patients with PXE under 40 years, increasing age did not have a statistically significant effect on the RPE-BM peak reflectivity (patients under 20 years: 44.2 [IQR, 40.5-74.6]; 20-30 years: 66.0 [IQR, 45.1-83.8]; 30-40 years: 70.8 [IQR, 49.0-88.0], P = 0.47). Conclusions BM calcification can be measured as increased RPE-BM reflectivity in young patients with PXE and has a high discriminative value. Translational Relevance In patients with PXE, the OCT reflectivity of Bruch's membrane may be the first biomarker for Bruch's membrane calcification and a valuable ophthalmologic endpoint in clinical trials.
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Affiliation(s)
- Sara Risseeuw
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Edwin Bennink
- Image Sciences Institute, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Maarten G Poirot
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Wilko Spiering
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Saskia M Imhof
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Redmer van Leeuwen
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Gong P, Almasian M, van Soest G, de Bruin DM, van Leeuwen TG, Sampson DD, Faber DJ. Parametric imaging of attenuation by optical coherence tomography: review of models, methods, and clinical translation. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-34. [PMID: 32246615 PMCID: PMC7118361 DOI: 10.1117/1.jbo.25.4.040901] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/28/2020] [Indexed: 05/07/2023]
Abstract
SIGNIFICANCE Optical coherence tomography (OCT) provides cross-sectional and volumetric images of backscattering from biological tissue that reveal the tissue morphology. The strength of the scattering, characterized by an attenuation coefficient, represents an alternative and complementary tissue optical property, which can be characterized by parametric imaging of the OCT attenuation coefficient. Over the last 15 years, a multitude of studies have been reported seeking to advance methods to determine the OCT attenuation coefficient and developing them toward clinical applications. AIM Our review provides an overview of the main models and methods, their assumptions and applicability, together with a survey of preclinical and clinical demonstrations and their translation potential. RESULTS The use of the attenuation coefficient, particularly when presented in the form of parametric en face images, is shown to be applicable in various medical fields. Most studies show the promise of the OCT attenuation coefficient in differentiating between tissues of clinical interest but vary widely in approach. CONCLUSIONS As a future step, a consensus on the model and method used for the determination of the attenuation coefficient is an important precursor to large-scale studies. With our review, we hope to provide a basis for discussion toward establishing this consensus.
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Affiliation(s)
- Peijun Gong
- The University of Western Australia, Department of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, Perth, Western Australia, Australia
- Address all correspondence to Peijun Gong, E-mail:
| | - Mitra Almasian
- University of Amsterdam, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Gijs van Soest
- Erasmus MC, University Medical Center Rotterdam, Department of Cardiology, Rotterdam, The Netherlands
| | - Daniel M. de Bruin
- University of Amsterdam, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Ton G. van Leeuwen
- University of Amsterdam, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - David D. Sampson
- The University of Western Australia, Department of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, Perth, Western Australia, Australia
- University of Surrey, Surrey Biophotonics, Guildford, Surrey, United Kingdom
| | - Dirk J. Faber
- University of Amsterdam, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
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Lee GI, Park KA, Oh SY, Kong DS. Analysis of Optic Chiasmal Compression Caused by Brain Tumors Using Optical Coherence Tomography Angiography. Sci Rep 2020; 10:2088. [PMID: 32034270 PMCID: PMC7005681 DOI: 10.1038/s41598-020-59158-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 12/10/2019] [Indexed: 11/10/2022] Open
Abstract
We have quantitatively evaluated the macular and peripapillary microvascular changes in eyes with chiasmal compression caused by brain tumors compared with healthy control eyes using optical coherence tomography angiography (OCT-A) and correlated them with other ocular parameters. This cross-sectional study involved the analysis of 36 eyes of 36 patients with chiasmal compression and age and refractive error-matched 35 healthy control eyes. OCT-A was used to generate microvascular images of the superficial and deep retinal capillary plexus (SRCP, DRCP) and the radial peripapillary capillary (RPC) segment in the macula and peripapillary areas. Automated segmentation and vessel density measurements facilitated the analysis of each layer. Macular OCT-A analysis revealed a significant reduction in vessel density in the SRCP (P = 0.004) of the nasal quadrant (P < 0.001) and in the same quadrant of the DRCP (P = 0.019) in the eyes with chiasmal compression compared with the control eyes. The RPC segment vessel density has also been significantly reduced in the eyes with chiasmal compression (P < 0.001). The RPC segment and the SRCP vessel densities were correlated with the peripapillary retinal nerve fiber layer and the ganglion cell layer complex thicknesses. The RPC segment and the nasal quadrant SRCP and the DRCP vessel densities were correlated with visual field defect. Significant microvascular alterations have been detected in the eyes with chiasmal compression compared with the control eyes. This study confirmed that chiasmal compression caused by brain tumors not only induced a loss of ganglion cells but also resulted in intra-retinal microvascular changes.
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Affiliation(s)
- Ga-In Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Doo-Sik Kong
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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19
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Visual loss and recovery in chiasmal compression. Prog Retin Eye Res 2019; 73:100765. [DOI: 10.1016/j.preteyeres.2019.06.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/05/2019] [Accepted: 06/12/2019] [Indexed: 12/18/2022]
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20
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Jeon C, Park KA, Hong SD, Choi JW, Seol HJ, Nam DH, Lee JI, Shin HJ, Kong DS. Clinical Efficacy of Optical Coherence Tomography to Predict the Visual Outcome After Endoscopic Endonasal Surgery for Suprasellar Tumors. World Neurosurg 2019; 132:e722-e731. [PMID: 31421301 DOI: 10.1016/j.wneu.2019.08.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Prediction of visual outcome after endoscopic endonasal tumor resection still remains a challenge. We investigated the prognostic value of the preoperative peripapillary retinal nerve fiber layer (pRNFL) using optical coherence tomography for visual outcome after endoscopic endonasal surgery (EES) for suprasellar tumors. METHODS We retrospectively analyzed 122 patients who underwent EES for sellar and suprasellar tumors between January 2016 and January 2018. We retrospectively analyzed the pre- and postoperative relationship between pRNFL thickness and visual outcome based on visual acuity (visual acuity score) and visual field (mean deviation [MD]). RESULTS Preoperatively, 216 eyes (mean global pRNFL thickness, 94.3 ± 12.4 μm; 88.5%) were included in the normal pRNFL group (≥70 μm) and 28 eyes (mean global pRNFL thickness, 54.3 ± 11.0 μm; 11.5%) were included in the thin pRNFL group (<70 μm). There was a very strong correlation between pre- and postoperative pRNFL thickness (r = 0.930). The thin pRNFL group showed a stronger correlation between pre- and postoperative MDs than the normal pRNFL group (r = 0.619 and r = 0.420, respectively; P < 0.01). Multivariate analyses identified pRNFL thickness as the only significant predictor of postoperative visual acuity (odds ratio [OR], 25.02; 95% confidence interval [CI], 7.68-81.50; P < 0.01) and visual field (OR, 39.46; 95% CI, 10.39-149.83; P < 0.01). CONCLUSIONS Preoperative pRNFL thickness plays a prognostic value in postoperative visual outcome after EES for sellar and suprasellar tumors. Patients with pRNFL thickness ≥70 μm before surgery are more likely to improve visual outcome than those with thickness <70 μm.
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Affiliation(s)
- Chiman Jeon
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Duk Hong
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Won Choi
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho Jun Seol
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do-Hyun Nam
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Il Lee
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Jin Shin
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Doo-Sik Kong
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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The role of optical coherence tomography in the evaluation of compressive optic neuropathies. Curr Opin Neurol 2019; 32:115-123. [DOI: 10.1097/wco.0000000000000636] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Zhang L, Xiang D, Jin C, Shi F, Yu K, Chen X. OIPAV: an Integrated Software System for Ophthalmic Image Processing, Analysis, and Visualization. J Digit Imaging 2018; 32:183-197. [PMID: 30187316 DOI: 10.1007/s10278-017-0047-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Ophthalmic medical images, such as optical coherence tomography (OCT) images and color photo of fundus, provide valuable information for clinical diagnosis and treatment of ophthalmic diseases. In this paper, we introduce a software system specially oriented to ophthalmic images processing, analysis, and visualization (OIPAV) to assist users. OIPAV is a cross-platform system built on a set of powerful and widely used toolkit libraries. Based on the plugin mechanism, the system has an extensible framework. It provides rich functionalities including data I/O, image processing, interaction, ophthalmic diseases detection, data analysis, and visualization. By using OIPAV, users can easily access to the ophthalmic image data manufactured from different imaging devices, facilitate workflows of processing ophthalmic images, and improve quantitative evaluations. With a satisfying function scalability and expandability, the software is applicable for both ophthalmic researchers and clinicians.
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Affiliation(s)
- Lichun Zhang
- School of Electronics and Information Engineering, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu Province, 215006, China
| | - Dehui Xiang
- School of Electronics and Information Engineering, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu Province, 215006, China
| | - Chao Jin
- School of Electronics and Information Engineering, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu Province, 215006, China
| | - Fei Shi
- School of Electronics and Information Engineering, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu Province, 215006, China
| | - Kai Yu
- School of Electronics and Information Engineering, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu Province, 215006, China
| | - Xinjian Chen
- School of Electronics and Information Engineering, Soochow University, No.1 Shizi Street, Suzhou, Jiangsu Province, 215006, China.
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