Supplementary Material for: Optical coherence tomography abnormalities as the presenting sign of an involuted sellar/suprasellar mass

Introduction: Pituitary adenomas are benign tumors that can lead to visual loss through compression of the optic chiasm. Patients with pituitary adenomas often present with visual field defects (commonly bitemporal hemianopia), but some may be asymptomatic. In such cases, abnormalities may only be detected through visual field testing or optical coherence tomography (OCT) of the ganglion cell-inner plexiform layer (GCIPL), may provide a more sensitive method for detecting such abnormalities. Case presentation: A 72-year-old man was incidentally found to have binasal OCT-GCIPL thinning during a routine eye examination. Visual acuity was 20/20 in both eyes. Pupils were equal and reactive without a relative afferent pupillary defect. His Humphrey 24-2 SITA-Fast visual field test results were normal. An MRI revealed a non-enhancing (cystic) sellar/suprasellar mass measuring 1.7 cm craniocaudal by 2.1 cm anteroposteriorly, without associated optic chiasm compression. The lesion was suspected to be either a cystic pituitary adenoma or a Rathke’s cleft cyst. Follow-up examination one year later showed all findings remained stable, including an unchanged visual acuity, visual fields, OCT-GCIPL and MRI. Conclusion: The binasal thinning observed on OCT-GCIPL in this case, despite the absence of chiasmal compression on MRI, is suggestive of previous compression of the optic chiasm. This case highlights the potential for spontaneous regression of pituitary adenomas and underscores the importance of OCT-GCIPL as a vital tool for detecting optic chiasmal damage.引言：垂体腺瘤（pituitary adenomas）是一类良性肿瘤，可通过压迫视交叉（optic chiasm）引发视力丧失。垂体腺瘤患者常表现为视野缺损（多为双颞侧偏盲），部分患者可无明显临床症状。此类情况下，眼部异常可能仅能通过视野检查或神经节细胞-内丛状层（ganglion cell-inner plexiform layer, GCIPL）的光学相干断层扫描（optical coherence tomography, OCT）检出，而OCT-GCIPL或是检测此类异常的更为敏感的手段。 病例报告：1例72岁男性患者在常规眼科检查中偶然发现双眼鼻侧OCT-GCIPL变薄。双眼视力均为20/20。瞳孔等大等圆，对光反射灵敏，无相对性传入性瞳孔障碍（relative afferent pupillary defect）。Humphrey 24-2 SITA-Fast视野检查结果正常。磁共振成像（magnetic resonance imaging, MRI）显示存在1个大小为头尾径1.7cm、前后径2.1cm的无强化囊性鞍区/鞍上肿物，未伴视交叉受压征象。该病变疑似为囊性垂体腺瘤或拉克氏囊囊肿（Rathke’s cleft cyst）。1年后的随访检查显示所有观测指标均保持稳定，包括视力、视野、OCT-GCIPL结果及MRI影像均无变化。 结论：本病例中尽管MRI未提示视交叉受压，但OCT-GCIPL检出的鼻侧变薄提示患者既往曾存在视交叉受压情况。该病例凸显了垂体腺瘤存在自发性消退的可能性，并强调了OCT-GCIPL作为检测视交叉损伤重要工具的临床价值。