Dry Eye Syndrome in Patients with Pituitary Tumors With and Without Transsphenoidal Tumor Resection

Dry eye syndrome (DES) is a multifactorial disease which can contribute significant morbidity. Some hormonal disturbances have been associated with DES, and animal studies have shown hypophysectomy can cause regression of lacrimal glands; this relationship has not been studied in humans. We hypothesized transsphenoidal pituitary tumor resection would be associated with DES.

Poster 194 Dry Eye Syndrome in Patients with Pituitary Tumors with and without Transsphenoidal Tumor Resection Christian Bardan1, Timothy Winter2, Frank Hwang2 1 Loma Linda University School of Medicine, Loma Linda, California, USA, 2Loma Linda University Eye Institute, Loma Linda, California, USA Introduction: Dry eye syndrome (DES) is a multifactorial disease which can contribute significant morbidity. Some hormonal disturbances have been associated with DES, and animal studies have shown hypophysectomy can cause regression of lacrimal glands; this relationship has not been studied in humans. We hypothesized transsphenoidal pituitary tumor resection would be associated with DES. Methods: Retrospective analysis of 203 patients with pituitary tumors who received eye exams within the last 7 years found 77 patients with transsphenoidal surgery. Patients with history of ocular surface disease, eye surgery, glaucoma medication, head radiation, or autoimmune disease associated with dry eye were excluded. We compared 43 patients with documented eye exams. Suspicion for dry eye was based on suggestive physical exam findings (tear film debris, tear lake deficiency, corneal punctate epithelial erosions) and Schirmer testing. The primary outcome was percentage of patients with dry eye after transsphenoidal pituitary tumor resection. Secondary outcomes included percentage of patients with dry eye on hormone replacement therapy. Analysis used chi-square independence tests. Results: Dry eye was present in 50% of patients after transsphenoidal surgery but 88% of nonsurgical patients (χ2(1, N=14) = 2.36, p = 0.124). Hormone replacement therapy was used in 37% of post-surgical patients and was associated with lower suspicion for dry eye when compared with patients not on hormones (31% vs 41%), though this was not statistically significant (χ2(2, N=35) = 2.51, p = 0.285). Conclusions: Patients with transsphenoidal tumor resection may be at lower risk for DES. In patients with resected tumors, hormone replacement may be protective against DES. Prospective studies might better evaluate these relationships. References: Azzarolo AM, Bjerrum K, Maves CA, et al. Hypophysectomy-induced regression of female rat lacrimal glands: Partial restoration and maintenance by dihydrotestosterone and prolactin. Investig Ophthalmol Vis Sci. 1995; 36(1): 216-226. McClellan KA, Robertson FG, Kindblom J, et al. Investigation of the role of prolactin in the development and function of the lacrimal and Harderian glands using genetically modified mice. Investig Ophthalmol Vis Sci. 2001; 42(1): 23-30. Peck T, Olsakovsky L, Aggarwal S. Dry eye syndrome in menopause and perimenopausal age group. J Midlife Health. 2017; 8(2): 51. Keywords: Tumors, Skull base, Miscellaneous Financial Disclosures: The authors had no disclosures. Grant Support: None. Contact Information: None provided. 346 | North American Neuro-Ophthalmology Society