Dados do Trabalho

Título

Optical Compression Changes in Patients With Selar Injury: A Tertiary Hospital Study

Resumo

Introduction: Sellar tumors are classified according to size, presence of compressive symptoms and functionality. When the lesion is large and has a suprasellar extension, it can compress the optic chiasm and may evolve with ophthalmological changes. Optical coherence tomography (OCT) can determine the thickness of the nerve fiber layer (NFL) and its division by quadrants, being of significant relevance in chiasmatic compressions due to its predilection for the nasal region of the optic nerve, and its correlation with data already classically obtained by campimetry.
Objective: The present study aims to evaluate the changes in optical compression of patients with a sellar lesion, using visual computerized campimetry (VCC) and OCT.
Methods: This is a longitudinal analytical observational study whose design is a retrospective cohort. By reviewing the attendance records, information was collected regarding demographic and clinical data, data from the magnetic nuclear resonance of the sellar region and the eye examination.The research was approved by the Research Ethics Committee of the hospital, complying with ethical principles.
Results: Seven patients were selected for the study, with ophthalmological assessment before and after treatment. Unilateral hemianopsia was the most common symptom, present in 57.1% of patients (n = 4), followed by bitemporal hemianopsia and headache. All cases (n = 7) had suprasellar extension and compression of the optic chiasm and only 14.3% (n = 1) of the cases had parasellar extension. In the analysis through VCC, the mean of Mean Deviation (MD) was -21.03 dB ± 6.27 (-24.42 dB) in pre-treatment and 15.29 dB ± 10.32 (-21, 51 dB) in post treatment. In optic nerve analysis through OCT, the mean NFL thickness was 73.86µm ± 22.88 (7550µm) in the pre-treatment and 70.42 (69.50µm) in the post. Those who showed better thickness of the MD fiber layer in the pre-tratment, also showed better values in the recovery of campimetry and visual acuity. Patients with better NFL thickness on OCT also had the best results on MD in post treatment.
Conclusions: These data reinforce the importance of a complete ophthalmologic evaluation as a means of determining the possibility of visual improvement in the treatment of pituitary tumors, in addition to demonstrating its effectiveness in decompressing the optic pathway, especially the chiasm. It also suggests that the OCT should be used as a tool to assess the patient's visual prognosis.

Palavras Chave

Sellar tumors; Visual campimetry; Optical coherence tomography.