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Optical coherence tomography in pituitary tumor

Author: YanHaiYan
Tutor: WuZhiFeng
School: Nanjing Medical University
Course: Ophthalmology
Keywords: Optical coherence tomography Retinal nerve fiber layer Thickness Pituitary tumor Visual function Prognosis
CLC: R736.4
Type: Master's thesis
Year: 2009
Downloads: 7
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Abstract

The first part of optical coherence tomography measurement of the normal human retinal nerve fiber layer thickness Objective: The application of optical coherence tomography (OCT) measurements of normal human retinal nerve fiber layer (RNFL) thickness value and the average value of each quadrant of; analysis RNFL each quadrant The difference between the thickness values ??and the relationship between age, gender, eye. Method: OCT 89 cases (169) normal people to papilledema ring scan, scan diameter 3.46mm, record average and quadrant RNFL thickness values ??and analyze other relationship with the age, gender and eye . Results: 89 cases of normal RNFL average thickness: temporal quadrant (89.62 ± 11.68) μm, upper quadrant (140.58 ± 12.30) μm, nasal quadrant (87.04 ± 12.06) μm, inferior quadrant (141.38 ± 13.20) μm-wide weekly average ( 113.20 ± 10.44) μm;, under the temporal side, and average RNFL thickness values ??and a negative correlation between age and the RNFL thinning with age; different gender of each quadrant and average RNFL thickness mean difference was not significant sex (P = 0.154 to 0.829); between normal people left and right eye each quadrant and average RNFL thickness there was no significant difference (P = 0.396 to 0.976). Conclusion: OCT quantitative detection of normal human RNFL thickness; thinner RNFL thickness increased with age; each quadrant RNFL thickness values ??independent of the gender and eye do. The second part of the the postoperative retinal nerve fiber layer thickness and visual field studies of patients with pituitary tumors Objective: To investigate the optical coherence tomography (optical coherence tomography, OCT) to measure the retinal nerve fiber layer (retinal nerve fiber layer, RNFL) thickness in patients with pituitary tumors significance in the follow-up of visual function. : January 2006 to June 2008 in our hospital by the pathological diagnosis of pituitary tumors and MRI suprachiasmatic oppression exists 39 patients (39 eyes) in patients with pituitary tumors underwent OCT and visual field (VF) check, while 76 normal subjects (76) line OCT examination, compare and calculate the correlation of average RNFL thickness and visual field mean defect each quadrant and average RNFL thickness in normal subjects and patients with pituitary tumors. Results: reduce patients with pituitary tumors quadrant and average RNFL thickness than normal people, and the difference was statistically significant (P lt; 0.000). The average RNFL thickness and visual field mean defect was positively correlated (R = 0.41, p lt; 0.000). Conclusion: OCT effective quantitative detection of RNFL damage location and extent objectively reflect the RNFL structural damage in patients with pituitary tumors, and certain defects found with the perimetry, visual function in patients with pituitary tumors follow-up clinical A new means. The third part of the optical coherence tomography judge prognosis of postoperative visual function of patients with pituitary tumors Objective: To study the instrument optical coherence tomography (OCT) to measure the thickness of the retinal nerve fiber layer (RNFL) determine postoperative visual function in patients with pituitary tumors prognosis. Methods: A prospective case series study. Of January 2007 to December 2008 in our hospital by pathological examination, MRI diagnosed 16 cases (32 eyes) pituitary tumor patients associated with optic chiasm compression, before surgery, a week after surgery and postoperative March, respectively. the Carl Zeiss StratusOCT Ⅲ fast RNFL thickness scan scan mode and Humphrey visual field analyzer the SITA strategy of 24-2 testing procedures to detect patients with an average RNFL thickness, of four quadrants RNFL thickness and visual field mean defect (MD). SPSS13.0 statistical software for data analysis. With or without improvement of visual field defects in preoperative and postoperative vision, the subjects were divided into three groups. Between-group differences in patient age, using independent sample t-test; preoperative group between MD and average RNFL thickness, quadrant RNFL thickness compared using analysis of covariance (net of age and the same patient eyes included in the study affected); using logistic regression model analysis of preoperative visual field defect, preoperative average RNFL thickness and quadrant RNFL thickness were improved postoperative visual field defects (net of the effect of age). P lt; 0.05 as the difference was statistically significant. Results: 16 patients (32 eyes) patients in group 1 (preoperative visual field defects that do not improve or worsen postoperative visual field defects) of 10 eyes, visual field defects in the 2 groups (preoperative, postoperative visual field defects improvement) of 11 eyes, Group 3 (preoperative and postoperative There was no visual field defects) of 11 eyes. Group 1 patients were significantly older than the age of patients of Group 2 and Group 3 (P = 0.003,0.003). Preoperative visual field defects in patients with average RNFL The thicker, the greater the improvement in the proportion of visual field defects (OR = 1.189, P = 0.020); below RNFL thickness improve visual field defects have a significant effect (OR = 6.093, P = 0.000), preoperative MD improve postoperative visual field defects had no significant effect (OR = 0.955, P = 0.509). Conclusion: The use of OCT for detecting patients with pituitary tumors average RNFL thickness and below the RNFL thickness, as judged by the patients more sensitive to short-term prognosis of visual function indicators, but the exact mechanisms urgent need for further research.

Optical coherence tomography in pituitary tumor

Abstract

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