Optical Coherence Tomography Angiography for the Differentiation of Glaucoma from Pituitary Macroadenoma Related Optic Disc Measurements

Alon Zahavi*, Yehonatan Weinberger, Noa Geffen, Itay Gabbay, Michael Mimouni, Orly Gal-or, Hadas Stiebel-Kalish, Dan D. Gaton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine the potential of optical coherence tomography (OCT) and OCT angiography (OCTA) to distinguish between glaucoma and pituitary macroadenoma by optic disc appearance. Methods: This prospective case-control study comprised 31 patients: 23 with glaucoma (18 male, 5 female) and 8 with pituitary macroadenoma and chiasmatic compression (3 male, 5 female). The corresponding mean ages were 72.8 years (range 58–90) and 60.7 years (range 43–73). All participants underwent complete ophthalmological examination, spectral domain OCT and OCTA, and visual field testing. Clinical, imaging, and visual field results were compared between the groups. Results: On OCT analysis, the glaucoma group had relatively lower peripapillary retinal nerve fiber layer (RNFL) thickness (65.79 ± 15.46, 86.0 ± 11.37, respectively, P = .002) and lower rim area (1.00 ± 0.22 mm2 and 1.2 ± 0.15 mm2, respectively, P = .005). On OCTA, peripapillary vessel density was significantly lower in all quadrants in the glaucoma group. The significance of these between-group differences was maintained when patients were stratified by visual field mean deviation. Conclusions: This is the first comparative analysis of optic disc morphology between glaucoma and pituitary macroadenoma using combined OCT and OCTA. The results yielded lower peripapillary RNFL thickness, lower rim area, and lower peripapillary vessel density in the glaucoma group. These parameters may aid in the initial differentiation between these two optic neuropathies.

Original languageEnglish
Pages (from-to)625-629
Number of pages5
JournalSeminars in Ophthalmology
Volume38
Issue number7
DOIs
StatePublished - 2023

Keywords

  • Glaucoma
  • optical coherence tomography
  • optical coherence tomography angiography
  • pituitary macroadenoma
  • visual fields

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