The Role of Optical Coherence Tomography Angiography in the Evaluation of Chiasmal and Retrochiasmal Compression

The compression of the visual pathway is associated with structural retinal changes due to retrograde neurodegeneration. It was brought into question whether visual pathway compression is also associated with retinal vascular changes as assessed by optical coherence tomography angiography (OCT-A). The objective of this review is to discuss the role of OCT-A in the evaluation of patients with tumours of the sellar, parasellar, and retrochiasmal regions. The reported OCT-A parameters were the vessel densities of radial peripapillary capillary network, macular superficial vascular plexus and/or macular deep vascular complex. Optic nerve and macular OCT-A parameters were impaired in patients versus controls. These changes were associated with altered structural OCT parameters and visual field defects. OCT-A could be considered a marker of neurodegeneration in addition to structural OCT, and it has the potential to become a visual prognostic tool in patients with visual pathway compression.