Fundus Blood Flow in Patients with Sellar Lesions with Optic Nerve Bending and Chiasmal Compression

Background/objectives: Optic nerve bending and chiasmal compression impair vision in patients with sellar lesions; however, their effect on optic nerve head (ONH) blood flow remains unclear. This study used laser speckle flowgraphy to examine the relationship between clinical features and ONH blood flow in patients with optic nerve bending and chiasmal compression. Methods: This retrospective study included 32 eyes (16 eyes with and 16 without optic nerve bending on the contralateral side) from 16 patients with sellar lesions. The best-corrected visual acuity (BCVA), simple visual field impairment score (SVFIS), optic nerve head mean blur rate (ONH-MBR), and six-segmented macular ganglion cell layer + inner plexiform layer (GCL + IPL) thickness were examined. Results: Preoperative BCVA and SVFIS in eyes with optic nerve bending were significantly worse than those in eyes without bending, and significantly correlated with the optic nerve-canal bending angle (ONCBA). After tumor resection, BCVA and SVFIS significantly improved in both groups. Preoperative ONH-MBR was significantly lower in bending eyes but increased significantly post-treatment in both groups. Preoperative ONH-MBR correlated with ONCBA, while postoperative ONH-MBR correlated with nasal GCL + IPL thickness. Conclusions: Optic nerve bending and chiasmal compression showed reduced blood flow to the ONH. These changes in blood flow may be associated with GCL + IPL thickness and optic nerve bending angle.