The Relationship Between Retinal Nerve Fiber Layer And Visual Field Defect

PurposeThe compression of optic chiasm by pituitary adenomas can cause the axonal degeneration of optical nerve,resulting the visual field defect.There is a definite error in traditional vision examination in the judgment of visual field defect.In recent years,optical coherence tomography(OCT)is a non-invasive.rapid ophthalmology examination.Besides providing fundus morphological data and measuring retinal nerve fiber layer(RFNL)thickness,we can evaluate the morphological range of visual field from the perspective of structure.The purpose of this study was to review the correlation between RNFL thickness and visual field defect in patients with pituitary adenomas.MethodsFifty-three patients were clinically and pathologically diagnosed with pituitary adenomas in the Department of Neurosurgery of Sir Run Run Shaw Hospital from January 2016 to February 2018.According to the mean deviation,it is divided into the lightly visual field defect group and the seriously visual field defect group.OCT measured the 4 quadrants and the average RNFL thickness,and calculated the size of the tumor from the magnetic resonance.The difference between the two groups was compared with the t-test to compare the RNFL thickness of the 4 quadrants and the RNFL average around the optic disc.The difference of the different quadrants of the same group was compared by single factor analysis.Pearson linear correlation analysis was used to compare the correlation between mean deviation(MD),average RNFL thickness,sex,ages and tumor volume.The multifactor analysis of the average RNFL thickness of the optic disc was analyzed by linear regression analysis.The definition of P<0.05 was statistically significant,and P<0.01 was of significant statistical significance.ResultsThe average RNFL thickness of the visual disc in the seriously visual field defect group was less than that in the lightly visual field group.The thickness of the superior-inferior side RNFL in the seriously visual field defect group was greater than that of the nasal temporal side.The quadrant RNFL thickness of the lightly visual field group from thick to thin was superior-inferior-nasal-temporal.No matter whether the field of view is defective or not,MD is positively correlated with the average RNFL thickness,which proves that the average RNFL thickness can replace MD to evaluate the condition of visual field defect.The more larger volume of tumor,and the more serious the visual field defect.The changes in the average RNFL thickness may appear earlier than MD when evaluating the visual field defect.ConclusionThe change of the average RNFL thickness is consistent with that of MD.The OCT examination is more convenient and objective than the field of view.Therefore,OCT can be used as an important index to evaluate the visual function of patients with pituitary adenoma.