The efficacy of microperimetry and contrast sensitivity test in the diagnosis of optic chiasm compression due to pituitary adenomas

Abstract

INTRODUCTION: The aim of the study was to determine which microperimetry and contrast sensitivity test parameters would prove the most valuable during diagnosing optic chiasm compression due to pituitary adenomas.
MATERIAL AND METHODS: A control group comprised healthy individuals (Group 1). Patients with pituitary macroadenoma were divided into two groups: Group 2 — absent optic chiasm compression; and Group 3 — present optic chiasm compression detected on contrastenhanced magnetic resonance imaging (MRI). Each group comprised 20 patients (40 eyes), i.e. a total of 60 patients (120 eyes) were examined. A complete ocular examination, intraocular pressure, microperimetry, contrast sensitivity test, kinetic Goldmann visual field, and static Octopus visual field test were performed.
RESULTS: Group 1 and 2 variables showed no statistically significant differences with respect to the mean sensitivity (MS) and mean defect (MD) in microperimetry. After dividing the microperimetry area into quadrants, a difference was shown in the mean sensitivity of the lower-nasal quadrant (MS LN) and mean defect of the lower-nasal quadrant (MD LN) between those groups. Receiver operating characteristic (ROC) curves analysis revealed that the microperimetry parameter — MS LN as well as row D and E contrast sensitivity test could be highly specific in the assessment of early damage of the optic nerve in patients suffering from pituitary adenoma.
CONCLUSIONS: Microperimetry and contrast sensitivity test are non-invasive diagnostic investigations adjunctive to MRI, which facilitate detection of early chiasmal compression caused by pituitary adenomas.