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Optical coherence tomography and visual evoked potentials in evaluation of optic chiasm decompression
Pavel Poczos1,2, Tomáš Česák3, Naďa Jirásková4
1Department of Neurosurgery, University Hospital Hradec Králové, Faculty of Medicine in Hradec Králové, Charles University, Sokolská 581, 500 05, Hradec Králové, Czech Republic. poczosp@lfhk.cuni.cz.
Scientific Reports
|February 9, 2022
Summary
Motion-onset visual evoked potentials (M-VEPs) better detect visual pathway changes after optic chiasm (OC) decompression surgery than pattern-reversal VEPs. Postoperative M-VEP improvements correlate with visual field recovery.
Area of Science:
- Ophthalmology
- Neuroscience
- Medical Imaging
Background:
- Optic chiasm (OC) compression causes visual impairment, often requiring surgical decompression.
- Assessing visual pathway function pre- and post-surgery is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the sensitivity of optical coherence tomography (OCT) and visual evoked potentials (VEPs) in detecting OC compression.
- To assess functional changes in the visual pathway after surgical decompression.
Main Methods:
- Prospective study of 16 patients indicated for OC decompression surgery.
- Measurements included visual acuity (VA), visual field (VF), retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thickness, and pattern-reversal (P-VEPs) and motion-onset VEPs (M-VEPs).
- Preoperative MRI determined OC compression degree; all parameters were assessed pre- and postoperatively.
Main Results:
- M-VEPs showed significant postoperative shortening of N160 peak time (p < 0.05).
- P-VEPs (P100) did not show significant changes in peak time or amplitude.
- M-VEPs N160 amplitude correlated with visual field improvement; RNFL thickness was not a limiting factor for functional outcomes.
Conclusions:
- M-VEPs are more sensitive than P-VEPs in detecting functional changes in the visual pathway after OC decompression.
- Sellar region morphology is important for evaluating chiasmal syndrome.
- M-VEP changes correlate with visual field recovery post-surgery.
