Recovery in pupillometric non-visual functions following chiasmal decompression in pituitary adenoma

ABSTRACT Background This study investigates visual and non-visual ( i.e., pupillometric) changes associated with optic nerve compression and decompression, and the potential role of chromatic pupillometry as an objective evaluation tool for visual dysfunction in pituitary adenoma (PA). Methods This longitudinal study included 27 patients with PA (median age = 55.4 years [IQR=23.4]) and 41 age-matched controls (53.6 [13.7] years), evaluated pre-operatively (7.0 ± 5.4 weeks prior to surgery) and post-operatively (12.0 ± 1.5 weeks post-surgery) with handheld chromatic pupillometry, in addition to comprehensive neuro-ophthalmological and neuroimaging examinations. Pupillometric features were analyzed for associations with structural changes and visual outcomes. Results Transsphenoidal surgery significantly reduced the upward displacement and increased the thickness of the optic chiasm measured on MRI (p0.05), regardless of VFI recovery. Structural recovery correlated with improved VFI (ρ= -0.62, p