Prognostic value of retinal nerve fiber layer thickness for postoperative peripheral visual field recovery in optic chiasm compression

García, T.; Sanchez, Stéphane; Litré, Claude Fabien; Radoi, C; Delemer, Brigitte; Rousseaux, P; Ducasse, A.; Arndt, Carl

doi:10.3171/2014.2.jns131767

Cited by 53 publications

(40 citation statements)

References 12 publications

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“…The utility of OCT as a predictive marker of axonal loss and visual recovery in chiasmal compression by tumors such as pituitary adenoma has already been well established by several publications. 6,10,14,16,24 In this study, we analyzed the usefulness of OCT as a tool for predicting visual recovery in patients with a parachiasmal meningioma compressing the anterior visual pathway.…”

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confidence: 99%

Use of optical coherence tomography to predict visual outcome in parachiasmal meningioma

Park

Oh²,

Kim

et al. 2015

JNS

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R estoRing vision in patients who have lost visual field (VF) or visual acuity (VA) as a result of a tumor compressing the visual pathway has always been a matter of great concern. It is a well-known fact that tumor resection and decompression of the affected anterior visual pathway can lead to visual recovery, but in many cases such recovery is variable and unpredictable. 18Numerous studies have identified predictive factors such as symptom duration, preoperative visual deficit, preoperative tumor size, and intraoperative and radiographic abbreviatioNs MD = mean deviation; OCT = optical coherence tomography; RGC = retinal ganglion cell; RNFL = retinal nerve fiber layer; SAP = standard automated perimetry; TSA = transsphenoidal approach; VA = visual acuity; VF = visual field. The authors investigated the value of retinal nerve fiber layer (RNFL) thickness in predicting visual outcome after surgery for parachiasmal meningioma. methods Forty-nine eyes of 25 patients who underwent craniotomy and resection of a parachiasmal meningioma were analyzed retrospectively. Visual parameters including visual field (VF) (recorded as the mean deviation [MD]), visual acuity (VA), and RNFL thickness (via optical coherence tomography) were measured before and 1 week, 6 months, and 1 year after surgery. Postoperative visual outcome was compared among the patients with a thin or normal RNFL. A separate analysis of data pertaining to 22 eyes of 13 patients with severe VF defects (MD ≤ -10 dB) was performed to compare visual outcome for those with a thin or normal RNFL. results Of the 23 eyes that showed VF improvement, 22 (95.7%) had normal RNFL thickness. The positive predictive value of normal RNFL thickness for VF improvement was 78.6%. The VF of patients with normal RNFL thickness improved in 6 months and continued improving 1 year after surgery (MD −5.9 dB before surgery, −5.5 dB 1 week after surgery, −2.8 dB 6 months after surgery [p < 0.01], and −1.1 dB 1 year after surgery [p < 0.01]). In contrast, those with a thin preoperative RNFL showed deterioration at first and then slower, worse visual recovery after surgery (MD -18.1 dB before surgery, −22.4 dB 1 week after surgery, −21.2 dB 6 months after surgery, and −19.1 dB 1 year after surgery). VA also showed significant progress 6 months after surgery in patients with normal RNFL thickness (0.6 before surgery, 0.7 one week after surgery, 0.9 six months after surgery [p = 0.025], and 0.9 one year after surgery [p = 0.050]) compared to those with a thin RNFL (0.3 before surgery, 0.2 one week after surgery, 0.3 six months after surgery, and 0.4 one year after surgery). Preoperative differences in VF MD and VA were noted between the 2 groups (p < 0.01). Even patients with severe VF defects and normal RNFL thickness improved by 11.1 dB by 1 year after surgery compared with patients with a thin RNFL (−0.01 dB) (p < 0.01). Patients with normal RNFL thickness also did better in VA improvement (from 0.7 to 1.1) than those with a thin RNFL (from 0.2 to 0.3), but these results were not ...

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confidence: 99%

Use of optical coherence tomography to predict visual outcome in parachiasmal meningioma

Park

Oh²,

Kim

et al. 2015

JNS

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“…Symptoms of the visual eld in pituitary tumor cases involve prominently the peripheral visual eld [3][4][5][6][7][8][9]. Therefore, experienced technicians measured the visual eld with Goldmann kinetic perimetry (GP; L-1560, Inami, Japan), which can measure the peripheral visual eld.…”

Section: Quanti Cation Of the Visual Eld 221 Measuring The Visual Eldmentioning

confidence: 99%

“…Several previous studies have discussed the factors that affect postoperative visual elds [1][2][3][4][5][6] but were unable to predict postoperative visual elds using preoperative data. Yoneoka et al [1] focused on the relationship between the visual eld and retinal thickness, and stated that early intervention would result in good postoperative visual eld outcome.…”

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confidence: 99%

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Prediction of Postoperative Visual Field Size from Preoperative Optic Chiasm Shape in Patients with Pituitary Adenoma

Ito

Yoneoka

Hatase

et al. 2015

ABE

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Pituitary tumors frequently compress the optic chiasm, causing visual eld de cits. Surgical removal of these tumors could improve visual functions. Thus, predicting the prognosis of visual eld function is required, but currently there is no method for predicting postoperative visual eld status from preoperative data of tumor and optic chiasm characteristics. In this study, we performed preoperative evaluation of visual eld prognosis using numerical parameters in 40 patients with pituitary tumors. Data from 30 patients were used to calculate the regression equation and those from the remaining 10 patients were used to con rm the validity of these equations. We de ned quantitative values (area of tumor, A tumor ; curvature of chiasm, C chiasm ; and area of chiasm, A chiasm ) based on tumor size, tumor shape, and optic chiasm shape as determined using magnetic resonance imaging. We determined pre-and postoperative visual eld sizes by ophthalmologic methods, and quanti ed them as numerical values (TNR). Postoperative recovery of the visual elds (obtained by comparing the post-and preoperative visual elds) was con rmed by increased postoperative TNRs (P < 0.01 for 4 isopters and P = 0.01 for 1 isopter, t-test). We attempted to predict postoperative visual eld size using preoperative A tumor , C chiasm , and A chiasm . Multiple regression analysis was performed, and three signi cant regression equations for predicting visual eld size were obtained (N = 30, P < 0.01, F-test). The measured and predicted visual eld sizes showed strong correlation (N = 10, r > 0.70). Thus, the quantitative parameters de ned in this study clearly predicted postoperative visual functions in patients with pituitary tumor, and could nd clinical applications in preoperative evaluation of visual eld prognosis in neurosurgery.

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“…The duration of mass effect and preoperative visual acuity are commonly used to estimate the postoperative outcome. Garcia et al 4 showed that the thickness of the nasal retinal nerve fiber layer appears to be a predictor of peripheral visual field recovery, but the threshold at which surgical decompression is warranted has yet to be defined. In the era of flow diverters, these cases illustrate the newer challenges faced by vascular neurosurgeons and the need to address the mass effect on the optic apparatus expeditiously and effectively.…”

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confidence: 99%

Letter to the Editor: Surgical bailout of giant supraclinoid ICA aneurysm following treatment with Pipeline Embolization Device

Brasiliense¹,

Navarro²,

Brazis³

et al. 2015

PED

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Prognostic value of retinal nerve fiber layer thickness for postoperative peripheral visual field recovery in optic chiasm compression

Abstract: Peripheral visual field recovery after surgery for optic chiasm compression is predicted by nasal RNFL thickness, which is in accordance with the retinotopy of retinal ganglion cells, as nasal axons decussate at the optic chiasm.

Cited by 53 publications

References 12 publications

Use of optical coherence tomography to predict visual outcome in parachiasmal meningioma

Use of optical coherence tomography to predict visual outcome in parachiasmal meningioma

Prediction of Postoperative Visual Field Size from Preoperative Optic Chiasm Shape in Patients with Pituitary Adenoma

Letter to the Editor: Surgical bailout of giant supraclinoid ICA aneurysm following treatment with Pipeline Embolization Device

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