Optical coherence tomography retinal ganglion cell complex analysis for the detection of early chiasmal compression
- 272 Downloads
To report patients with sellar tumors and chiasmal compression with normal visual fields, who demonstrate damage to the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) on optical coherence tomography (OCT).
Seven patients with sellar tumors causing mass effect on the optic chiasm without definite visual field defect, but abnormal GCC are described. GCC/RNFL analyses using Cirrus-OCT were classified into centiles based on the manufacturer’s reference range.
In seven patients with radiologic compression of the chiasm by a sellar tumor, OCT-GCC thickness detected compressive chiasmopathy before visual defects became apparent on standard automated visual field testing. Without OCT, our patients would have been labelled as having normal visual function and no evidence of compressive chiasmopathy. With only OCT-RNFL analysis, 3/7 patients would still have been labelled as having no compression of the anterior visual pathways.
These patients show that OCT-GCC analysis is more sensitive than visual field testing with standard automated perimetry in the detection of compressive chiasmopathy or optic neuropathy. These cases and previous studies suggest that OCT-GCC analysis may be used in addition to visual field testing to evaluate patients with lesions compressing the chiasm.
KeywordsPituitary adenoma Sellar mass Chiasmal compression Optic neuropathy Visual field test Optical coherence tomography Ganglion cell complex analysis
This work was supported in part by an unrestricted departmental grant (Department of Ophthalmology) from Research to Prevent Blindness, Inc., New York, and by NIH/NEI core Grant P30-EY006360 (Department of Ophthalmology). Dr. Biousse received research support from NIH/PHS (UL1-RR025008). Dr. Newman is a recipient of the Research to Prevent Blindness Lew R. Wasserman Merit Award.
Compliance with ethical standards
Conflict of interest
No conflicting relationship exists for any author.
- 1.Casanueva FF, Barkan AL, Buchfelder M, Klibanski A, Laws ER, Loeffler JS, Melmed S, Mortini P, Wass J, Giustina A (2017) Pituitary society, expert group on pituitary tumors. Criteria for the definition of pituitary tumor centers of excellence (PTCOE): a pituitary society statement. Pituitary 20:489–498CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Newman SA, Turbin RE, Bodach ME, Tumialan LM, Oyesiku NM, Litvack Z, Zada G, Patil CG, Aghi MK (2016) Congress of neurological surgeons systematic review and evidence-based guideline on pretreatment ophthalmology evaluation in patients with suspected nonfunctioning pituitary adenomas. Neurosurgery 79:E530–E532CrossRefPubMedGoogle Scholar
- 5.Danesh-Meyer HV, Carroll SC, Foroozan R, Savino PJ, Fan J, Jiang Y, Vander Hoorn S (2006) Relationship between retinal nerve fiber layer and visual field sensitivity as measured by optical coherence tomography in chiasmal compression. Invest Ophthalmol Vis Sci 47:4827–4835CrossRefPubMedGoogle Scholar
- 7.Phal PM, Steward C, Nichols AD, Kokkinos C, Desmond PM, Danesh-Meyer H, Sufaro YZ, Kaye AH, Moffat BA (2016) Assessment of optic pathway structure and function in patients with compression of the optic chiasm: a correlation with optical coherence tomography. Invest Ophthalmol Vis Sci 57:3884–3890CrossRefPubMedGoogle Scholar
- 10.Monteiro ML, Hokazono K, Fernandes DB, Costa-Cunha LV, Sousa RM, Raza AS, Wang DL, Hood DC (2014) Evaluation of inner retinal layers in eyes with temporal hemianopic visual loss from chiasmal compression using optical coherence tomography. Invest Ophthalmol Vis Sci 55:3328–3336CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Azuara-Blanco A, Banister K, Boachie C, McMeekin P, Gray J, Burr J, Bourne R, Garway-Heath D, Batterbury M, Hernández R, McPherson G, Ramsay C, Cook J (2016) Automated imaging technologies for the diagnosis of glaucoma: a comparative diagnostic study for the evaluation of the diagnostic accuracy, performance as triage tests and cost-effectiveness (GATE study). Health Technol Assess 20:1–168CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Ferreras A, Polo V, Larrosa JM, Pablo LE, Pajarin AB, Pueyo V, Honrubia FM (2007) Can frequency-doubling technology and short-wavelength automated perimetries detect visual field defects before standard automated perimetry in patients with preperimetric glaucoma? J Glaucoma 16:372–383CrossRefPubMedGoogle Scholar