Jeong SS, Funari A, Agarwal V. Diagnostic and Prognostic Utility of Optical Coherence Tomography in Patients with Sellar/Suprasellar Lesions with Chiasm Impingement: A Systematic Review/ Meta-Analyses.
World Neurosurg 2022;
162:163-176.e2. [PMID:
35276393 DOI:
10.1016/j.wneu.2022.03.011]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND
In this review, we appraised the current literature on the utility of optical coherence tomography (OCT) as a diagnostic and predictive factor for postoperative visual function outcomes in patients with sellar/suprasellar lesions with chiasmal impingement.
METHODS
A systematic search of PubMed, CINAHL, Scopus, and Cochrane Library was conducted following PRISMA guidelines. Included studies described diagnostic or prognostic utility of OCT in patients with sellar/suprasellar lesions with chiasmal impingement. Meta-analysis was represented with mean difference (MD) with 95% confidence intervals. Meta-regression was performed to determine predictive factors of visual outcomes.
RESULTS
Forty-eight articles were identified for final pooled analysis, representing a total of 2,435 patients with compressive sellar/suprasellar lesions and 952 healthy controls. Mean age was 43.3(11.4) years, with 1,494(48.8%) male and 1,566(51.2%) female patients. Mean retinal nerve fiber layer(RNFL) was significantly different in the study population compared to healthy controls(75.8μ[13.2] vs 91.4μ[10.8], p<0.00001). The nasal segment of RNFL had the largest mean difference (MD -9.76[-12.39, -7.13], p<0.0001). Visual acuity, visual field mean deviation (VF-MD), and visual field pattern standard deviation, all showed significant differences between the study population and healthy controls as well(p<0.0001). Meta-regressions showed significant predictive capability of preoperative RNFL in determining visual function outcome (p<0.05).
CONCLUSION
Our findings provide promising support for the growing evidence that OCT parameters can be utilized as both a diagnostic and prognostic tool for patients with compression of the optic apparatus. There is a need for further studies to gain a better understanding of OCTs and to improve patient outcomes.
Collapse