Linyang Gan1, Jin Ma1, Feng Feng2, Yuhan Wang1, Jiantao Cui1, Xiaopeng Guo3, Xia Zhang1, Hui You2, Zihao Wang3, Zhenming Yin3, Yong Zhong4, Bing Xing3. 1. Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 2. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 3. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 4. Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: yzhong_eye@163.com.
Abstract
OBJECTIVE: To analyze the quantitative relationship between suprasellar extension (SSE) and visual function impairment in Chinese patients with nonfunctioning pituitary adenoma (NFPA) with optic chiasm compression. METHODS: We retrospectively reviewed 117 patients with NFPA and optic chiasm compression treated at our hospital between January 2013 and December 2016. The quantitative relationships between SSE detected on sagittal and coronal magnetic resonance imaging (MRI) sections and visual function, including visual acuity (VA) and visual fields (VFs), were analyzed. The cutoff value of SSE to predict a VF defect (VFD) was calculated using a receiver operating characteristic curve. The mean deviation (MD) value was used to quantitatively analyze the VFs, and multiple linear regression analysis was performed to investigate risk factors of VFD. RESULTS: Among 117 patients with NFPA, 77 (65.8%) had VFD, and the mean VA was 0.42 ± 0.38 logMAR. The cutoff value of the sagittal SSE was 14.0 mm, with 77.9% sensitivity and 80.0% specificity, and the cutoff value of the coronal SSE was 15.8 mm, with 81.8% sensitivity and 85.0% specificity. The values of SSE on 2 MRI sections were correlated with VA (P < 0.001) and the MD (P < 0.001). Multiple linear regression analysis demonstrated that SSE on sagittal views (P < 0.001), SSE on coronal views (P < 0.001), duration of the disease (P = 0.027), and apoplexy (P = 0.036) were related to the degree of VF damage. CONCLUSIONS: VFD in patients with NFPA with chiasm compression can be predicted by SSE on MRI. There is a linear correlation between SSE and the MD value.
OBJECTIVE: To analyze the quantitative relationship between suprasellar extension (SSE) and visual function impairment in Chinese patients with nonfunctioning pituitary adenoma (NFPA) with optic chiasm compression. METHODS: We retrospectively reviewed 117 patients with NFPA and optic chiasm compression treated at our hospital between January 2013 and December 2016. The quantitative relationships between SSE detected on sagittal and coronal magnetic resonance imaging (MRI) sections and visual function, including visual acuity (VA) and visual fields (VFs), were analyzed. The cutoff value of SSE to predict a VF defect (VFD) was calculated using a receiver operating characteristic curve. The mean deviation (MD) value was used to quantitatively analyze the VFs, and multiple linear regression analysis was performed to investigate risk factors of VFD. RESULTS: Among 117 patients with NFPA, 77 (65.8%) had VFD, and the mean VA was 0.42 ± 0.38 logMAR. The cutoff value of the sagittal SSE was 14.0 mm, with 77.9% sensitivity and 80.0% specificity, and the cutoff value of the coronal SSE was 15.8 mm, with 81.8% sensitivity and 85.0% specificity. The values of SSE on 2 MRI sections were correlated with VA (P < 0.001) and the MD (P < 0.001). Multiple linear regression analysis demonstrated that SSE on sagittal views (P < 0.001), SSE on coronal views (P < 0.001), duration of the disease (P = 0.027), and apoplexy (P = 0.036) were related to the degree of VF damage. CONCLUSIONS: VFD in patients with NFPA with chiasm compression can be predicted by SSE on MRI. There is a linear correlation between SSE and the MD value.
Authors: Iris C M Pelsma; Marco J T Verstegen; Friso de Vries; Irene C Notting; Marike L D Broekman; Wouter R van Furth; Nienke R Biermasz; Alberto M Pereira Journal: Pituitary Date: 2020-08 Impact factor: 4.107