Automated perimetry and laser polarimetry in the assessment of nerve fi bers involvement in pituitary adenoma

Purpose To point out nerve fi bers involvement in patients suff ering from pituitary adenomas and submitted to transphenoidal surgical intervention. Methods 17 patients (51+/-18 y) been selected to be submitted to a complete ophthalmic examination before and after surgery. h e postintervention examinations were scheduled at 1, 3, 6, 12 months. h e adenomas have been classifi ed according to Hardy classifi cation. A kinetic test (HFA-II, stimulus I/4) was performed as a screening and in case of abnormal outcomes a static test 24-2 or 30-2 was carried out to better characterized the visual fi eld (VF). h e laser polarimetry of the retinal nerve fi ber layer (RNFL) was performed with GDx-VCC. Results 3 adenomas were classifi ed as micro and 14 as macro with diff erent dimension and extrasellar extension. No patient suff ering from microadenoma had VF or RNFL damage. Among the macroadenomas, in one case reliable tests weren’t obtainable, 8 subjects had no clinic mark of nerve fi ber involvement, one had homonymous and GDx defects reproducible in the follow-up. 4 patients had a typical chiasmal defect before surgery and in 3 cases the VF got back to normal after surgery. h e only case with permanent bitemporal defect also pointed out a reproducible RNFL thinning with GDx. Conclusion h e nerve fi ber involvement can be pointed out only for macroadenomas with extrasellar extension classifi ed as 2/C but a strict correlation between the type of clinical defect and anatomical characteristics of tumors cannot be determined. h e nerve fi bers involvement seems to be mainly due to compression without fi ber loss as demonstrated by complete postoperative recovery of VF and normal GDx outcomes, noticed in most cases.