Bi-nasal sectors of ganglion cells complex and visual evoked potential amplitude as biomarkers in pituitary macroadenoma
Keywords:
pituitary macroadenoma, biomarkers, visual evoked potential, ganglion cell complexAbstract
Introduction: Pituitary macroadenoma surgery guarantees patient survival but not recovery of visual function.
Objective: To evaluate the retinal ganglion cell structure using optical coherence tomography and the visual pathway function employing visual evoked potentials in the diagnosis and monitoring of patients with pituitary macroadenoma.
Methods: It was conducted a descriptive, cross-sectional, and longitudinal study (3 and 12 months follow-up) on forty-two patients. They were included 42 patients in the longitudinal study, 37 in the cross-sectional and 35 controls matched to the program by propensity score. It was carried out full neuro-ophthalmological evaluation (structural and functional) including global and segmented retinal nerve fiber layer/ganglion cell complex analysis and amplitude and latency of P100 component in the electrophysiology. It was conducted statistical data analysis with R version 3.6.3 and Python version 3.8. They were evaluated associations using Spearman’s correlations.
Results: Amplitude sensitivities were 0.999, and bi-nasal sectors of ganglion cell complex thickness specificities were 0.999. This structural parameter had the highest diagnostic value (area under curve = 0.923). Significant associations were found between bi-nasal sectors with amplitude at 12′ (rho > 0.7, p < 0.01) and median deviation of the visual field (rho > 0.5, p < 0.01) at three months. Pre-surgical values of bi-nasal sectors and amplitude can predict post-surgically median deviation and amplitude (Oz, 12′) at three months with r2 > 0.5.
Conclusions: Bi-nasal sectors and P100 wave amplitude are efficient biomarkers of visual pathway damage for pituitary macroadenoma patients management. Pre-surgical values of the bi-nasal sector and visual evoked potentials amplitude could help to predict the restoration of parvocellular pathway traffic after decompression.
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