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Purpose To quantitatively investigate the characteristics of eyes with pituitary adenoma presented by three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) using three common indices, including thickness, optical intensity ratio, and optical intensity attenuation coefficient (OIAC). Methods The SD-OCT database of 38 patients with pituitary adenoma and 39 normal controls were included in the study. Quadrantal and average measurements of thickness, optical intensity ratio, and OIAC were calculated for macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL) combined with inner plexiform layer (IPL) (GCIPL) and/or the collective ganglion cell complex (GCC). The parameters of patients and controls were compared by unpaired t-test and Mann-Whitney U-test. The relationships between the optical intensity ratio and the thickness of mRNFL and GCIPL were evaluated by Pearson's correlation. Diagnostic performances of these indices were assessed using receiver operating characteristic (ROC) analysis. Results Significant decreases in thickness existed in the mRNFL and nasal GCC of patients compared with controls (p-values of 0.000 to 0.039). Optical intensity ratios in the relevant retinal layers of patients were almost all lower than those of controls. In patients, optical intensities were increased in the mRNFL but decreased in the GCIPL along with an increase of retinal thicknesses. The OIAC measurements were significantly higher in the upper quadrants and global average of the mRNFL in patients. The areas under the ROC curves (AUC) obtained by global average mRNFL thickness was significantly greater than that of the global average OIAC in the mRNFL (p = 0.0265). Conclusions Thicknesses of the mRNFL and nasal GCC were significantly decreased in the retinas of patients with pituitary adenoma compared with controls. The differences of the optical intensity ratio and OIAC between patients and controls were not all statistically significant. Thickness was more sensitive than optical characteristics indices in distinguishing pituitary adenoma from controls.

Background Over the past several decades, the endoscopic endonasal transsphenoidal approach (EETA) has gradually become a preferred option of pituitary adenomas surgery because of its minimal invasiveness and high efficiency. However, some EETA operations were performed through one nostril (mononostril), while other EETA operations were performed through both nostrils (binostril). Therefore, we conducted this study to compare the pros and cons of these two methods in an attempted to confirm which method is more effective. Methods We executed a systematic literature search of PubMed, the Cochrane Library, and the Web of Science and Medline (1992–2015). The language is limited to English and all studies should meet the inclusion criteria. Comparisons were made for postoperative outcomes, complications, and other relevant parameters between the mononostril and the binostril group. Statistical analyses of categorical variables were undertaken by the use of Stata 12.0 and SPASS 19.0. Results Thirty studies, involving 4805 patients, were included. The two groups had similar results in GTR rate (included GTR rate of macroadenomas), hormonal remission rate, improvement in visual function, postoperative CSF leak, permanent diabetes insipidus, meningitis, and sinusitis. The binostril group had less temporary diabetes insipidus (2.9% vs. 5.3%, p = 0.022), less anterior pituitary insufficiency (2.3% vs. 6.4%, p = 0.000) and few hospitalization days (3.2 days vs. 4.4 days, p

Background Patients with pituitary adenomas usually receive “stress dose” steroids in the peri-operative peroids. Though randomized controlled trials(RCT) have not been performed to assess the necessity of steroid coverage, there are several studies that explained the changes of adrenal function during peri-operative peroids. The aim of the present study is to investigate whether it is necessary to employ conventional peri-operative glucocorticoid replacement therapy to all the patients undergoing surgery. Methods We searched studies addressing peri-operative steroids coverage for pituitary adenomas in the Web of Science, Medline and the Cochrane Library. Then we extracted studies about peri-operative morning serum cortisol(MSC) levels, morbidity of early postoperative adrenal insufficiency, postoperative diabetes insipidus, relationships between MSC levels and adrenal integrity. We used RevMan Software to combine the results for meta-analysis. We used fixed-effects models for there was no significant heterogeneity existed. Findings There are 18 studies from 11 countries published between 1987 and 2013 including 1224 patients. The postoperative serum cortisol levels were significantly increased compared with the preoperative one in hypothalamic-pituitary-adrenal axis(HPAA) functions preserved patients(P