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Abstract
Objective To test the hypothesis that there was a temporal change in the retinal microstructure after decompression surgery for chiasmal compression, the 1-year longitudinal changes in the inner and outer retinal thickness after decompression surgery were analyzed using spectral-domain optical coherence tomography (SD-OCT) with linear mixed-effects models.
Methods SD-OCT was obtained from 87 eyes with chiasmal compression and compared to 100 healthy controls. The preoperative and 1-year postoperative longitudinal changes in the retinal layer thickness were measured. The thickness of each of the following retinal layers was analyzed: the macular retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), the inner plexiform layer (IPL), the inner nuclear layer, the outer plexiform layer, the outer nuclear layer, and the photoreceptor layer.
Results The RNFL, GCL, and IPL showed thinning at a rate of 1.068 μm/y (95% confidence interval [CI], 0.523, 1.613), 1.189 μm/y (95% CI 0.452, 1.925), and 1.177 μm/y (95% CI 0.645, 1.709), respectively, after decompression surgery. The preoperative thickness of the intraretinal layer was associated with postoperative visual field recovery (RNFL, odds ratio [OR] 1.221, 95% CI 1.058, 1.410; GCL, OR 1.133, 95% CI 1.024, 1.254; and IPL, OR 1.174, 95% CI 1.002, 1.376).
Conclusions The changes in retinal microstructure persisted and progressed in eyes with chiasmal compression after decompression surgery. The findings provide insight into the biological and anatomical sequelae following chiasmal compression. The preoperative thickness of the inner retinal layers was associated with postoperative visual field recovery.
Glossary
- AUC=
- area under the curve;
- AUROC=
- area under the receiver operating characteristic curve;
- BCVA=
- best corrected visual acuity;
- CI=
- confidence interval;
- GCC=
- ganglion cell layer complex;
- GCL=
- ganglion cell layer;
- INL=
- inner nuclear layer;
- IPL=
- inner plexiform layer;
- MD=
- mean deviation;
- OCT=
- optical coherence tomography;
- ONL=
- outer nuclear layer;
- OPL=
- outer plexiform layer;
- OR=
- odds ratio;
- PRL=
- photoreceptor layer;
- pRNFL=
- peripapillary retinal nerve fiber layer;
- RGC=
- retinal ganglion cell;
- RNFL=
- retinal nerve fiber layer;
- SD-OCT=
- spectral-domain optical coherence tomography;
- SE=
- standard error;
- SER=
- spherical equivalent refractive error;
- VF=
- visual field
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
- Received February 25, 2020.
- Accepted in final form August 20, 2020.
- © 2020 American Academy of Neurology
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