Background: This study aimed to evaluate longitudinal changes in retinal structure and their association with visual outcomes following surgical decompression.
Materials and Methods: In this retrospective cohort, 33 patients with histopathologically confirmed pituitary adenoma who underwent endoscopic transsphenoidal resection at a tertiary center between 2015 and 2021 were included. Preoperative and postoperative (3- and 6-month) OCT parameters including peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell–inner plexiform layer (GCIPL) thickness and volume were analyzed alongside visual acuity (VA) and visual field (VF) assessments. Repeated measures ANOVA was applied to evaluate structural changes over time, and Pearson correlation coefficients were calculated to assess associations between preoperative OCT parameters and visual outcomes.
Results: Significant postoperative changes were observed in retinal thickness and volume across multiple macular regions, with 6-month values generally higher than baseline in selected outer retinal compartments, including outer retinal tubulation (p < 0.05). No significant longitudinal changes were detected in RNFL or GCIPL. Preoperative retinal thickness and volume were strongly correlated with postoperative VA (r ≥ 0.7) and VF outcomes (r ≤ –0.7), indicating their predictive value for visual recovery.
Conclusions: OCT reveals dynamic structural remodeling of retinal layers following pituitary adenoma decompression. Preoperative retinal thickness and volume are robust predictors of postoperative visual function, highlighting the utility of OCT as both a diagnostic and prognostic tool. Integrating OCT into routine clinical practice may enhance patient counseling, surgical planning, and postoperative monitoring.