Clinical Efficacy of Optical Coherence Tomography to Predict the Visual Outcome After Endoscopic Endonasal Surgery for Suprasellar Tumors

Jeon, Chanhyung; Park, Kyung-Ah; Hong, Sang Duk; Choi, Jung Won; Seol, Ho Jun; Nam, Do‐Hyun; Lee, Jung-Il; Shin, Hyung Jin; Kong, Doo‐Sik

doi:10.1016/j.wneu.2019.08.031

Cited by 15 publications

(8 citation statements)

References 40 publications

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“…In keeping with the results reported in the previous studies ( 14 , 18 , 33 – 35 ), our research showed that preoperative OCT parameters can effectively predict visual outcome after EEES for adult craniopharyngiomas. Interestingly, increased inferior cpRNFL thickness was significantly associated with higher odds of VF recovery and maintenance (p = 0.046) in the present study, which was consistent with the results reported in the earlier literature ( 16 , 37 ).…”

Section: Discussionsupporting

confidence: 90%

“…OCT allows quick, non-invasive, in vivo cross-sectional imaging of the retinal layers, acting as an important tool for objective quantification of cpRNFL and mGCC (18). There is increasing evidence suggesting that preoperative OCT parameters can serve as excellent prognostic indicators of visual outcome after surgery for parasellar lesions, such as meningioma, pituitary adenoma, and craniopharyngioma (14,18,(33)(34)(35). Among these tumors, craniopharyngiomas often directly adhere to the undersurface of optic nerves or chiasm, with a higher risk of postoperative visual deterioration (36).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Utility of Optical Coherence Tomography for Visual Outcome After Extended Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Qiao

et al. 2022

Front. Oncol.

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IntroductionOwing to the close vicinity of the optic chiasma, visual dysfunction is known as one of the most common surgical indications and postoperative complications in adult patients with craniopharyngiomas, probably leading to poor quality of life. Historically, very few consistent predictive factors associated with the visual outcome are identified, which may not be helpful for patient counseling and preoperative decision making. Recently, optical coherence tomography (OCT) serving as a novel high-resolution imaging technique can assess the retinal morphology by measuring the circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell complex thickness. However, few studies have examined the prognostic utility of OCT parameters for visual outcome after surgery for craniopharyngiomas. This study aims to use the largest series to evaluate the association between OCT parameters and visual outcome after extended endoscopic endonasal surgery (EEES) for primary craniopharyngiomas in adults.Material and MethodsFrom October 2018 to October 2020, one hundred and seventy eyes in 88 adult patients with newly confirmed craniopharyngiomas were retrospectively reviewed and pertinent prognostic factors were analyzed.ResultsGross total resection was performed in 82 (93.2%) patients. The median postoperative follow-up time was 10.9 months. Multiple logistic regression analysis showed that increased temporal cpRNFL thickness was associated with higher odds of visual acuity (VA) improvement and maintenance (OR = 1.070; 95% CI, 1.005–1.140; p = 0.035), and greater inferior cpRNFL thickness was significantly associated with visual field (VF) improvement and maintenance (OR = 1.034; 95% CI, 1.001–1.068; p = 0.046). Furthermore, tight adhesion between optic nerves and craniopharyngiomas was demonstrated as an independent adverse factor for either postoperative VA or VF (p = 0.048, p = 0.030, respectively). The ROC results further verified the robustness of the prediction model either in VA (AUC = 0.843; 95% CI, 0.734–0.952; p < 0.001) or VF (AUC = 0.849; 95% CI, 0.741–0.958; p < 0.001).ConclusionPreoperative OCT can effectively predict visual outcome after EEES for adult craniopharyngiomas. It can also serve as a reliable alternative to evaluate preoperative visual field defects, especially for patients with lower compliance. Tight adhesion was confirmed as an independent risk factor for postoperative visual outcome. The OCT-based multivariable prediction models developed in the present study may contribute to patient counseling on visual prognosis.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Prognostic Utility of Optical Coherence Tomography for Visual Outcome After Extended Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Qiao

et al. 2022

Front. Oncol.

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“…9 Of ophthalmic structural parameters, the loss of peripapillary retinal nerve fiber layer thickness (pRNFLT), measured with optical coherence tomography (OCT), indicates loss of retinal ganglion cell axons resulting from chronic compression of the optic chiasm. 10 There have been various studies supporting the use of pRNFLT as a prognostic factor for postoperative visual recovery after ETSS-PA. [11][12][13][14][15] However, these studies did not evaluate the postoperative visual functions in terms of their actual values. Instead, they evaluated outcomes in terms of postoperative visual recovery, i.e.…”

Section: Introductionmentioning

confidence: 99%

“…10 In addition, they included individuals with PA who had undergone tumor resection and/or radiotherapy prior to enrollment. 13 Therefore, the primary goal of our study was to evaluate the utility of preoperative pRNFLT for predicting postoperative visual functions in terms of their actual values among Thai subjects with PA who were treated with ETSS-PA alone.…”

Section: Introductionmentioning

confidence: 99%

“…For example, a study conducted in South Korea reported that preoperative global pRNFLT ≥ 23.6 µm was associated with better postoperative VF defect recovery after ETSS-PA. 14 Moreover, there were also other limitations in the previous studies. 10 , 13 First, they included both transsphenoidal and transcranial approaches in the cohorts without separate analysis on either condition. 10 In addition, they included individuals with PA who had undergone tumor resection and/or radiotherapy prior to enrollment.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Peripapillary Retinal Nerve Fiber Layer Thickness as the Prognostic Factor of Postoperative Visual Functions After Endoscopic Transsphenoidal Surgery for Pituitary Adenoma

Thammakumpee¹,

Buddawong²,

Vanikieti³

et al. 2022

OPTH

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To evaluate the prognostic ability of preoperative peripapillary retinal nerve fiber layer thickness (pRNFLT) for predicting postoperative visual functions, including the visual field index (VFI) and visual acuity (VA), of subjects with pituitary adenoma (PA) who were treated with endoscopic transsphenoidal surgery for pituitary adenoma (ETSS-PA) exclusively. Subjects and Methods: This 11-year retrospective study was performed at a single institution in Thailand. Sixty-six eyes of 33 subjects who had a PA compressing the anterior visual pathway and were treated with ETSS-PA alone were included. The pRNFLT was measured globally and in the four quadrants preoperatively, using optical coherence tomography. Multivariable analysis and area under the curve (AUC) were used to demonstrate the prognostic ability of preoperative pRNFLT for postoperative visual functions (> 1 month but < 6 months after ETSS-PA). Results:The mean postoperative VFI and median postoperative VA were 79.45% ± 24.24% and 0.14 [interquartile range: 0.02, 0.40] logarithm of the minimum angle of resolution. Among the 56 eyes with a reliable postoperative VFI, thicker preoperative temporal (odds ratio, 1.18; p = 0.024) and inferior (odds ratio, 1.07; p = 0.013) pRNFLT values were associated with a postoperative VFI > 90%. The strongest association occurred with the preoperative temporal pRNFLT (AUC = 0.821, 95% CI: 0.720-0.923) with a cut-off value of 60 µm. Multivariable analysis for all 66 eyes showed that thicker preoperative inferior-quadrant pRNFLT (odds ratio, 1.05; p = 0.001) was associated with a postoperative VA of at least 20/25. The strongest performance was found with the preoperative inferior pRNFLT (AUC = 0.732, 95% CI: 0.615-0.849) with a cut-off value of 105 µm. Conclusion: Preoperative pRNFLT offers clinical utility for predicting visual functions after ETSS-PA. Temporal pRNFLT ≥ 60 µm and inferior pRNFLT ≥105 µm predicted postoperative VFI > 90% and postoperative VA better than or equal to 20/25, respectively.

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Stereotactic radiosurgery for orbital cavernous venous malformation: a single center’s experience for 15 years

et al. 2020

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Clinical Efficacy of Optical Coherence Tomography to Predict the Visual Outcome After Endoscopic Endonasal Surgery for Suprasellar Tumors

Cited by 15 publications

References 40 publications

Prognostic Utility of Optical Coherence Tomography for Visual Outcome After Extended Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Prognostic Utility of Optical Coherence Tomography for Visual Outcome After Extended Endoscopic Endonasal Surgery for Adult Craniopharyngiomas

Preoperative Peripapillary Retinal Nerve Fiber Layer Thickness as the Prognostic Factor of Postoperative Visual Functions After Endoscopic Transsphenoidal Surgery for Pituitary Adenoma

Stereotactic radiosurgery for orbital cavernous venous malformation: a single center’s experience for 15 years

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