Correlation between macular and retinal nerve fibre layer Fourier-domain OCT measurements and visual field loss in chiasmal compression

Abstract

Purpose The aim of this study was to test the correlation between Fourier-domain (FD) optical coherence tomography (OCT) macular and retinal nerve fibre layer (RNFL) thickness and visual field (VF) loss on standard automated perimetry (SAP) in chiasmal compression. Methods A total of 35 eyes with permanent temporal VF defects and 35 controls underwent SAP and FD-OCT (3D OCT-1000; Topcon Corp.) examinations. Macular thickness measurements were averaged for the central area and for each quadrant and half of that area, whereas RNFL thickness was determined for six sectors around the optic disc. VF loss was estimated in six sectors of the VF and in the central 16 test points in the VF. The correlation between VF loss and OCT measurements was tested with Spearman's correlation coefficients and with linear regression analysis. Results Macular and RNFL thickness parameters correlated strongly with SAP VF loss. Correlations were generally stronger between VF loss and quadrantic or hemianopic macular thickness than with sectoral RNFL thickness. For the macular parameters, we observed the strongest correlation between macular thickness in the inferonasal quadrant and VF loss in the superior temporal central quadrant (q ¼ 0.78; Po0.001) whereas for the RNFL parameters the strongest correlation was observed between the superonasal optic disc sector and the central temporal VF defect (q ¼ 0.60; Po0.001).Conclusion Although FD-OCT RNFL and macular thickness measurements were both correlated with VF loss, the correlation was stronger with quadrantic macular than with RNFL thickness measurements in patients with temporal hemianopia. Such measurements could potentially be used to quantify neuronal loss in patients with chiasmal compression.

Comparison of the Pattern of Retinal Ganglion Cell Damage Between Patients With Compressive and Glaucomatous Optic Neuropathies

“…1), which is consistent with previous findings. 16,19,[30][31][32] The nasal and temporal cpRNFL thinning is consistent with the classic band atrophy of the ONH that can be seen in patients with a chiasmal tumor and preservation of uncrossed fibers. 16 On the other hand, the cpRNFL showed thinning in all sectors except for the T and NS sectors in GON, with the thinning being most notable in the TS and TI sectors (Fig.…”

“…However, the thinning of the mGCL was more distinct in the nasal subfields than in the temporal subfields, most especially in the IN subfield relative to the IT subfield. The selective damage of the nasal hemiretina is well documented in CON, 17,19,21,29 and is attributable to the axons originating from the nasal hemiretinal RGCs comprising crossing fibers that are close to the chiasm-compressing mass. The temporal hemiretinal fibers can also be damaged when the mass enlarges and affects the noncrossing fibers, eventually causing total macular RGC loss.…”

Macular thickness measurements with frequency domain-OCT for quantification of axonal loss in chronic papilledema from pseudotumor cerebri syndrome

“…As the RGC layer accounts for a significant percentage of the thickness in the macular area, estimates of macular thickness can be used to investigate possible RGC layer loss, as demonstrated in eyes with glaucoma, [19][20][21] and compressive 2,[22][23][24] or demyelinating optic neuropathies. 4,25,26 However, no study has yet evaluated the ability of macular thickness measurements to estimate axonal loss following papilledema.…”

Avaliação da camada de fibras nervosas da retina nas afecções neuroftalmológicas da via óptica anterior

“…(72,(74)(75)(76) Estudos demonstraram que existe correlação entre a gravidade da perda visual e as medidas de perda axonal retiniana seja pela CFNR seja pela espessura macular. (75,(77)(78) A quantificação da perda neural nas compressões quiasmáticas é também importante no sentido de tentar estimar a possibilidade de recuperação visual. Para isso, é de fundamental importância estudos de correlação estrutura-função, ou seja, verificar como se correlacionam os defeitos permanentes do campo visual com a perda da CFNR.…”

“…Assim, nos pacientes que apresentam perda de campo sem comprometimento das fibras nervosas existe a possibilidade de recuperação visual importante, ao passo que aqueles com lesão grave das fibras nervosas não apresentam recuperação. (77,(79)(80)(81) …”