Retinal Microvascular Alterations Detected by Optical Coherence Tomography Angiography in Nonfunctioning Pituitary Adenomas

Purpose: Visual impairment assessment plays a significant role in diagnosis and clinical decisions in nonfunctioning pituitary adenoma (NFPA). Retinal microvascular alterations may potentially reflect the visual impairment. The purpose of this study was to evaluate fundus microvascular alterations in patients with NFPA. Methods: Comparisons of visual field, retinal structure, and microcirculation were conducted between patients with NFPA and age- and sex-matched healthy controls. Multivariate regression modeling was used to assess the relationship between symptom duration, sellar mass size, and fundus vessel density (VD) of patients. Receiver operating characteristic (ROC) curves were depicted to determine the diagnostic performance of significant parameters to discriminate eyes with NFPA from healthy eyes. Results: Forty eyes of patients and 40 eyes of healthy individuals were enrolled. Compared to healthy controls, patients with NFPA had a larger foveal avascular zone area and thinner ganglion cell complex thickness. The VDs of patients presented an obvious decrease in radial peripapillary capillary (RPC) and an increase in the deep capillary plexus segment of the perifoveal area. The peripapillary VDs of patients were significantly related to sellar mass size. The area under the ROC curve of VD in the RPC segment of the temporo-inferior sector was the largest (0.801; 95% confidence interval, 0.70-0.90; P < 0.001). Conclusions: The fundus of patients with NFPA demonstrated significant and characteristic microvascular impairments. The VDs were also significantly associated with sellar mass size. Translational Relevance: Retinal microvascular alterations detected by optical coherence tomography angiography are characteristic and related to sellar mass size, which may provide information that facilitates the diagnosis of NFPA.