Optical Coherence Tomography (OCT) in Pituitary and Suprasellar Lesions: Systematic Review/Meta-Analysis

Introduction: Optical coherence tomography (OCT) has been used to create high-resolution cross-sectional and three-dimensional images of tissues in a non-invasive, inexpensive, reproducible, and rapid fashion. Because of its ability to measure the thickness of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) it has recently evolved as a promising imaging modality for preoperative assessment and prognosis in patients with pituitary and suprasellar lesions with or without optic compression. In this review, we appraised the current literature on the utility of OCT as a diagnostic tool for pituitary lesions and as a predictive factor for postoperative visual function outcomes.

Methods: A comprehensive search of PubMed, Scopus, CINAHL, and Cochrane Library was performed on September 1, 2021. All searches were performed with a wide focus and were filtered by English and Human subjects. The search, screening, and eligibility of the articles were performed by two independent reviewers. When a disagreement occurred, the relevant articles were discussed between the reviewers until consensus was reached. The search workflow was designed in adherence to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. The inclusion criteria were as follows: (1) English used as a language, (2) human subjects, (3) OCT as method for investigation, (4) patient population must have presence of pituitary lesions, (5) full article online, and (6) studies indicate utility of OCT in diagnosis or postoperative predictive outcome of pituitary lesions. Exclusion criteria were as follows: (1) animal studies, (2) case reports and case series with n < 10, (3) systematic reviews/meta-analysis, and (4) non-journal publications (editorials, commentaries, etc).

Results: This review identified 37 articles for a final pooled analysis. Data regarding demographics, comorbidities, type of pituitary lesion, varying OCT measurements, and general utility of OCT in diagnostic and predictive outcome values of pituitary lesions were collected. Preliminary results reveal total N = 2768 patients with 1409 (51%) males and 1342 (49%) females. Pooled mean age is 43.25 (11.44). The vast majority of articles highlighted the utility of OCT as a diagnostic tool (62.2%) or OCT as a predictive tool for outcomes (56.8%); only a select few mentioned both (24.3%). A more thorough review is currently in progress.

Conclusion: The results of this preliminary review indicate there is established utility of OCT in diagnosing pituitary adenomas earlier than visual field testing and before visual defects present. Our findings also seem to suggest the utility of OCT as a predictive prognostic tool in patients with compression of the optic apparatus. Because this is a relatively new area of interest, more studies are indicated to gain a better understanding and improve patient outcomes ([Figs. 1]–[2]).

Fig. 1

Fig. 2 Risk of bias graph review authors' judgements about each risk of bias item presented as percentages across all included studies.

Publikationsverlauf

Artikel online veröffentlicht:
15. Februar 2022