Ophthalmic Morphological Changes Detected in Patients With Prolactinoma

Patients with prolactinoma experience significant microvascular morphological changes, according to a study published in Microvascular Research.

Researchers enrolled 16 patients with prolactinoma (mean age [SD], 42.8 [11.11]; 9 women) and 15 age- and sex-matched control individuals (mean age [SD], 41.06 [9.83]; 8 women) in a comparative, cross-sectional analysis to evaluate changes in retinal and optic disc morphology in patients with prolactinoma. Patients underwent comprehensive examinations and optical coherence tomography angiography (OCT-A) was used to measure choriocapillaris flow, vessel density, and retinal nerve fiber layer (RNFL) thickness.

Among patients with prolactinoma, the average tumor size at diagnosis was 9.23 mm and patients received 0.81 mg of cabergoline per week for a mean [SD] 6.67 [3.76] months. A complete biological response was observed among 71.0% of the cohort.

According to the report, whole (60.59% vs 54.46%; P <.001), perifoveal (62.25% vs 56.20%; P <.001), and parafoveal (60.69% vs 57.37%; P =.021) macular deep capillary plexus vessel density values were higher among individuals with prolactinoma compared with control individuals.

No differences in superficial capillary plexus density, foveal avascular zone, or capillary flow parameters were observed.

Vessel density in the nasal quadrant of the optic disc was significantly reduced among patients with prolactinoma (46.06%) compared with control individuals (48.31%; P =.006).

The RNFL was significantly thinner in the inferior (133.79 vs 148.82 μm; P =.007) and nasal (92.21 vs 99.15 μm; P =.010) peripapillary quadrants, but significantly thicker in the temporal quadrant (81.41 vs 74.31 μm; P =.001) among individuals with prolactinoma compared with controls, respectively.

The report states that tumor size at diagnosis independently predicted deep foveal capillary plexus vessel density (β, 1.6; 95% CI, 1.21-2.45; P =.043).

Researchers acknowledge that OCT-A alone cannot adequately diagnose prolactinoma, but suggest their results show promise in identifying potential ocular complications caused by these tumors. “As structural OCT and OCTA data are combined, it may be possible to gain a better understanding of the prolactinoma patient’s condition, and as a result, a more reliable and comprehensive approach for early detection of prolactinoma-related ocular complications,” according to the report.

Study limitations include a small sample size and single center design.