Longitudinal Changes in Visual Field and Optical Coherence Tomography Parameters in Patients with Pituitary Microadenomas: A 12-Month Controlled Study

Background/Objectives: The ophthalmological course of pituitary microadenomas without overt chiasmal compression remains poorly understood. This study evaluated visual field and retinal structural changes over 12 months in patients with conservatively managed pituitary microadenomas. Methods: This prospective controlled study included 23 patients with pituitary microadenomas and 23 age- and sex-matched healthy controls. Examinations performed at baseline and after 12 months included best-corrected visual acuity, static and kinetic perimetry, and optical coherence tomography assessment of the ganglion cell–inner plexiform layer (GC-IPL), peripapillary retinal nerve fibre layer (RNFL), and central macular thickness. Results: Visual acuity and visual field index remained stable in both groups. Mean deviation was lower in the microadenoma group in both eyes at baseline and after 12 months. Baseline mean deviation differentiated patients from controls, with an area under the curve of 0.820 for the right eye and 0.773 for the left eye. Pattern standard deviation increased in both eyes of patients with microadenomas but remained unchanged in controls. Kinetic perimetry showed no consistent pattern of longitudinal change. GC-IPL, RNFL, and central macular thickness remained stable during follow-up. Conclusions: Conservatively managed pituitary microadenomas may be associated with static perimetric differences despite preserved visual acuity and stable retinal structure. The clinical significance of these exploratory findings remains uncertain and warrants evaluation in larger confirmatory studies with longer follow-up.