Invited Commentary: Ganglion Cell Complex Measurement in Compressive Optic Neuropathy

Horton, Jonathan C.

doi:10.1097/wno.0000000000000489

Cited by 13 publications

(12 citation statements)

References 13 publications

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“…While a majority of the research have focused on measuring the peripapillary retinal nerve fiber layer (pRNFL) [6,12,15], recent data suggest the ganglion cell layer-inner plexiform layer (GCL-IPL) of the macula may be a more accurate and reliable biomarker of vision [7,8,10,17,18]. GCC thinning, according to numerous authors, remained relatively unchanged before and after decompression [17][18][19][20], found in our patient, as well.…”

Section: Discussionsupporting

confidence: 69%

“…In recent years it has been established that patients who have objectively measurable RNFL loss and loss of retinal ganglion cell complex (GCC) at the time of surgery for chiasmal compressive lesions are less likely to have recovery of VA or VF after surgery [9][10][11][12][13][14][15][16]. Thinner preoperative RNFL and macular GCC thickness was found to be associated with worse visual acuity (VA) and VF after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…With the development of optical coherence tomography (OCT), more objective measurements of optic nerve damage and more objective prediction of visual outcome after treatment of pituitary adenomas have become available [7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of optical coherence tomography in chronic chiasmal compression

et al. 2021

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Introduction. Sellar and parasellar region lesions, such as pituitary adenoma often lead to the compression of the optic chiasm. Consequentialy, visual field (VF) defects and loss of visual acuity (VA), is a common complaint in these patients. The aim of this study is to evaluate if optical coherence tomography (OCT), measuring retinal nerve fibre layer (RNFL) and ganglion cell complex thickness (GCC), offers a reliable prediction of visual outcome in patients with chronic chiasmal compression from a pituitary macroadenoma. Case outline. We present a case of chronic chiasmal compression from a pituitary macroadenoma with an initial binocular visual field defect and low values of OCT parameters binocularly. The average value of RNFL on the right eye pre/postoperatively was 48/79 ?m, while on the left eye it was 56/63 ?m. The average value of GCC pre/postoperatively was 47/46 microns on the right and 45/46 microns on the left eye. Six weeks after surgical optochiasmal decompression macular GCC on both eyes and RNFL on the left eye remained largely unchanged, while RNFL of the right eye exhibits increases in thickness, as the postoperative consequence of the removal of conduction block. Neither visual field, nor visual acuity shows postoperative improvement. Conclusion. Irreversible damage of GCC and RNFL by longstanding compression results in poor visual outcome after surgery. Ganglion cell layer of the macula is a more accurate and reliable indicator of postoperative visual outcome.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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Prognostic value of optical coherence tomography in chronic chiasmal compression

et al. 2021

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“…Previous studies have shown a RNFL loss in PA patients with chiasmal compression (Monteiro et al 2004;Johansson & Lindblom 2009). Recently, OCT macular segmentations have allowed acute measurements of the macular ganglion cell complex (GCC) thickness, which correlate better with visual field defects than RNFL measurements in patients with chiasmal compression (Akashi et al 2014;Horton 2017;Banc et al 2018). The GCC analysis provides very useful information because it may also detect compressive chiasmopathy without visual field defects visible on standard automated visual field testing (Blanch et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Retinal microvasculature in pituitary adenoma patients: is optical coherence tomography angiography useful?

Dallorto

Lavia

Jeannerot

et al. 2019

Acta Ophthalmologica

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To examine retinal vascular changes in the peripapillary and macular areas in patients with pituitary adenoma (PA) using optical coherence tomography angiography (OCTA). Methods: Cross-sectional, retrospective study of 17 consecutive PA patients and 16 healthy subjects. All patients underwent a neuro-ophthalmological examination to assess the presence of optic neuropathy (ON). Static automated perimetry (SAP), macular and optic disc structural OCT [retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) thicknesses] and OCTA were performed. Pituitary adenoma (PA) patients with ON were compared to those without ON and to healthy subjects. Results: Optic neuropathy (ON) was found in 16 eyes of nine PA patients. Peripapillary vessel density (ppVD) and macular vessel density (VD) in the superficial vascular plexus were significantly decreased in PA eyes with ON, compared to healthy eyes (45.21 AE 5.69 versus 50.52 AE 2.14% and 43.79 AE 5.03% versus 48.96 AE 2.94%, respectively). No significant difference in VD was observed in the macular deep vascular complex (DVC) between groups. Pituitary adenoma (PA) patients with ON had a mean ppVD reduction by 10.51% compared to healthy subjects. RNFL and GCC thicknesses were significantly reduced in PA eyes with ON compared to the other groups. Peripapillary VD (ppVD) significantly correlated with RNFL thickness and SAP mean deviation. Conclusions: Optical coherence tomography angiography showed a significant decrease in ppVD and superficial macular VD in PA eyes with ON compared to healthy eyes, according to RNFL and GCC thinning. Together with the absence of DVC alterations, it may provide further insights into neurovascular coupling.

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“…Therefore, GCC evaluation might be useful both for diagnosis and for follow-up of children with suspected central nervous system pathology who are unable to undergo visual field testing. However, visual field testing should be performed whenever possible, since depending on the clinical situation, both OCT and perimetry have advantages and disadvantages for the detection of chiasmal compression [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Macular ganglion cell complex thinning in children with visual field defects due to central nervous system pathology

Noval

Henríquez-Recine

Contreras

et al. 2019

Eye

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Purpose To study the relationship between macular ganglion cell complex (GCC) thickness and visual field defects (VFD) caused by central nervous system (CNS) lesions in children and evaluate the possibility of predicting VFD according to GCC maps. Methods The GCC maps of a group of children with VFD due to CNS lesions with respect of the vertical meridian in at least one eye (study group), as well as of children with other neuro-ophthalmological problems and healthy children were presented to two masked evaluators, who were asked to predict the patients’ VFD on the basis of GCC damage: the evaluators classified VFD as normal, hemianopia (homonymous or heteronymous) or diffuse. Results Seventeen patients were included in the study group, with a median age of 12 years. Fifteen had brain tumours and two epilepsy. The mean MD of the affected hemifields was −26.00 dB (SD 7.89 dB) versus −5.51 dB (SD 3.52 dB) for the nonaffected hemifields, p < 0.001. The mean GCC thickness was of 56.04 μm (SD 11.95 μm) in the affected hemiretinas versus 74.31 μm (SD 10.64 μm) for the non-affected, p < 0.001. Kappa coefficients between VFD and those estimated by the evaluators were 0.705 and 0.658 ( p < 0.001) for evaluators 1 and 2. Conclusions GCC thickness can reflect damage to the visual pathway and GCC maps may be useful to identify chiasmal and retrochiasmal lesions, since GCC atrophy in most of these cases respects the vertical meridian. GCC maps might be used as a surrogate marker for visual damage in patients unable to perform perimetry.

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Invited Commentary: Ganglion Cell Complex Measurement in Compressive Optic Neuropathy

Cited by 13 publications

References 13 publications

Prognostic value of optical coherence tomography in chronic chiasmal compression

Prognostic value of optical coherence tomography in chronic chiasmal compression

Retinal microvasculature in pituitary adenoma patients: is optical coherence tomography angiography useful?

Macular ganglion cell complex thinning in children with visual field defects due to central nervous system pathology

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