The effects of surgical androgen deprivation therapy for advanced prostate cancer on peripapillary retinal nerve fiber layer thickness

Abstract

Background: Prostate cancer is the most common malignancy in men, and androgen deprivation therapy (ADT) serves as the primary approach for managing advanced cases. Certain research has suggested the impact of androgens on the physiological homeostasis of the optic nerve. Our aim was to investigate the impact of surgical ADT on peripapillary retinal nerve fiber layer (RNFL) thickness in patients with advanced prostate cancer. Methods: The study comprised 30 patients who had undergone bilateral orchiectomy for advanced prostate cancer, with a total of 60 eyes included in the analysis. Each participant received a standard ophthalmological examination. Peripapillary RNFL thickness measurements were performed preoperatively and 12 months postoperatively using optical coherence tomography. Results: The mean age of the patients was 73.77 ± 8.8 years. At the 12th month following surgery, we observed that the mean average thickness of the right and left RNFL, as well as the thickness of the left nasal, left inferior, and right and left temporal quadrants, was significantly thinner compared to presurgical values (P <.05). However, when comparing pre-and postsurgical measurements, the RNFL thickness in the right and left superior quadrants, as well as the right nasal and right inferior quadrants, showed no statistically significant difference. Conclusion: In this study, a significant difference was observed between the preoperative and 12-months postoperative peripapillary RNFL thickness values in patients who underwent surgical ADT for advanced prostate cancer. Additional research using larger sample sizes is required to clinically examine the impact of ADT on optic nerve homeostasis.