Predictive visual field outcomes after optic chiasm decompressive surgery by retinal vessels parameters using optical...

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Medical Imaging

Background:

• Optic chiasm compression from sellar region masses can lead to visual field deficits.
• Assessing visual field recovery post-decompression is crucial for patient management.
• Non-invasive retinal imaging may offer predictive insights into visual recovery.

Purpose of the Study:

• To evaluate the predictive value of superficial retinal capillary plexus (SRCP) and radial peripapillary capillary (RPC) for visual field recovery after optic chiasm decompression.
• To compare the predictive capabilities of SRCP and RPC with peripapillary nerve fiber layer (pRNFL) and ganglion cell complex (GCC) thickness.

Main Methods:

• Prospective longitudinal observational study involving patients with chiasmal compression.
• Generalized estimating equations used to compare retinal vessel density and thickness pre- and post-operatively.
• Logistic regression models assessed the relationship between preoperative retinal parameters and visual field recovery.

Main Results:

• Preoperative RPC and SRCP vessel density and pRNFL/GCC thickness were reduced compared to healthy controls.
• The superior GCC (AUC=0.866), tempo-inferior pRNFL (AUC=0.824), and tempo-inferior RPC (AUC=0.825) showed strong predictive value for visual field recovery.
• No significant difference was found in the predictive accuracy between superior GCC, tempo-inferior pRNFL, and tempo-inferior RPC.

Conclusions:

• Optic chiasm compression reduces retinal thickness and perfusion, effects that persist post-surgery.
• Ganglion cell complex (GCC), peripapillary nerve fiber layer (pRNFL), and radial peripapillary capillary (RPC) are sensitive predictors of visual field recovery.
• These retinal parameters aid in predicting outcomes after decompression surgery for chiasmal compression.