Peripapillary Microvascularization Analysis Using Swept-Source Optical Coherence Tomography Angiography in Optic Chiasmal Compression

Abstract

Purpose. To evaluate the vessel density (VD) of the radial peripapillary capillary (RPC) network using swept-source optical coherence tomography angiography (SS-OCTA) “en face” images of eyes with chiasmal compression caused by brain tumors before and after decompressive surgery compared with healthy controls. Methods. A cross-sectional study was conducted in 12 patients with chiasmal compression confirmed by neuroimaging. Sixteen healthy participants were also included. All patients with chiasmal compression underwent a neuro-ophthalmological examination one week before and 6 months after brain surgery, including static automated perimetry as well as measurement of the thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell complex (GCC) with spectral-domain optical coherence tomography (SD-OCT). Based on this neuro-ophthalmological examination, the presence of an optic neuropathy (ON) was evaluated. Peripapillary VD was obtained in four sectors on a 6 × 6 mm SS-OCTA image using the Cirrus Plex Elite 9000. Results. Baseline average VD was significantly lower in patients with chiasmal compression and ON than in controls (median: 55.62; interquartile range (IQR): 2.96 vs. 58.53; IQR: 2.02; p = 0.003 ). This decrease was also found in the temporal, superior, and nasal sectors. Average postoperative VD was decreased in patients with chiasmal compression compared with average preoperative VD (median: 56.16; IQR: 4.07 vs. 57.48; IQR: 3.83; p = 0.004 ). Preoperative VD was significantly correlated with RNFL, GCC thickness, and visual field defects. Conclusions. The VD of the RPC network was decreased in chiasmal compressive ON, and it was further decreased at 6 months after decompressive surgery.

Analysis of OCTA Features of the Retina and DTI Features of the Visual Pathway in Patients with Pituitary Adenoma

“…Previous studies have found reduced RPCP and super cial macular capillary plexus density in PA patients [21][22]. This reduction is speculated to result from tumor growth compressing the optic chiasm, causing axoplasmic ow obstruction and reduced blood supply, leading to neural atrophy and ganglion cell death, which ultimately manifests as retinal vasoconstriction [23]. Our study identi ed reduced blood ow density in both the optic disc RPCP and all layers of the macular region, which aligns with the results of Gilda Cennamo and others [22].…”

The Value of Optical Coherence Tomography Angiography in Pituitary Adenomas

“…Previous research has suggested that the growth of pituitary tumors results in optic chiasm compression, leading to reduced axoplasmic transportation and blood supply [29,30]. The resulting nerve fiber atrophy and apoptosis of ganglion cells may lead to reduced oxygen demand in the retina, thus leading to blood vessel atrophy.…”

“…Wang et al [24] found that the RPC vascular density in the nasal and temporal quadrants was correlated to the RNFL thickness in the corresponding quadrants in 31 patients with brain tumors with optic chiasm compression. After studying 12 patients with brain tumors with optic chiasm compression, Ghezala et al [29] found that their RPC was significantly lower than healthy people. Our results support these previous results.…”