Functional Prognostic value of optical coherence tomography in optic chiasmal decompression: A preliminary study

Purpose. - To assess the predictive value for functional recovery of Ganglion Cell Complex Layer (GCC) and Retinal Nerve Fiber Layer (RNFL) measurements obtained by Optical Coherence Tomography (OCT) in patients undergoing chiasmal decompression and to define potential OCT thresholds for visual recovery. Methods. - We measured preoperative GCC and RNFL thickness in patients with a sellar and/or perisellar tumor compressing the optic chiasm. Visual recovery was defined as recovery of mean deviation (MD) and pattern standard deviation (PSD) using Humphrey visual field testing after 12 successful decompressions (24 eyes). Receiver operating characteristic curve (ROC) analysis was used to identify the best thresholds. Results. - Robust global and focal OCT thresholds were found. Superior GCC >= 63 mu m had the best functional prognostic value (AUC = 1) for visual improvement. Mean GCC >= 67 mu m and mean RNFL >= 75 mu m also had excellent predictive values (AUC > 0.9). Conclusion. - In this preliminary study, significant preoperative OCT thresholds for early visual recovery after chiasmal decompression were identified, mainly regarding GCC measurements. Further studies on larger cohorts with closely scheduled follow-up could refine our results. (C) 2021 Elsevier Masson SAS. All rights reserved.

Automated summary

The study assessed the predictive value of GCC and RNFL measurements obtained by OCT for functional recovery after chiasmal decompression. It identified robust OCT thresholds, with superior GCC >= 63 µm showing the best prognostic value for visual improvement. Further studies with larger cohorts are needed to refine these results.