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Yu WJ, Xiao J, Wang GX, Jiang C, Zha W, Liao RF. Predictive visual field outcomes after optic chiasm decompressive surgery by retinal vessels parameters using optical coherence tomography angiography. Int J Ophthalmol 2024; 17:365-373. [PMID: 38371253 PMCID: PMC10827611 DOI: 10.18240/ijo.2024.02.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/19/2023] [Indexed: 02/20/2024] Open
Abstract
AIM To evaluate the predictive value of superficial retinal capillary plexus (SRCP) and radial peripapillary capillary (RPC) for visual field recovery after optic cross decompression and compare them with peripapillary nerve fiber layer (pRNFL) and ganglion cell complex (GCC). METHODS This prospective longitudinal observational study included patients with chiasmal compression due to sellar region mass scheduled for decompressive surgery. Generalized estimating equations were used to compare retinal vessel density and retinal layer thickness pre- and post-operatively and with healthy controls. Logistic regression models were used to assess the relationship between preoperative GCC, pRNFL, SRCP, and RPC parameters and visual field recovery after surgery. RESULTS The study included 43 eyes of 24 patients and 48 eyes of 24 healthy controls. Preoperative RPC and SRCP vessel density and pRNFL and GCC thickness were lower than healthy controls and higher than postoperative values. The best predictive GCC and pRNFL models were based on the superior GCC [area under the curve (AUC)=0.866] and the tempo-inferior pRNFL (AUC=0.824), and the best predictive SRCP and RPC models were based on the nasal SRCP (AUC=0.718) and tempo-inferior RPC (AUC=0.825). There was no statistical difference in the predictive value of the superior GCC, tempo-inferior pRNFL, and tempo-inferior RPC (all P>0.05). CONCLUSION Compression of the optic chiasm by tumors in the saddle area can reduce retinal thickness and blood perfusion. This reduction persists despite the recovery of the visual field after decompression surgery. GCC, pRNFL, and RPC can be used as sensitive predictors of visual field recovery after decompression surgery.
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Affiliation(s)
- Wen-Juan Yu
- Department of Ophthalmology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Jin Xiao
- Department of Neurosurgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Guang-Xin Wang
- Department of Ophthalmology, the First People's Hospital of Hefei, Hefei 230061, Anhui Province, China
| | - Chang Jiang
- Department of Ophthalmology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Wei Zha
- Department of Ophthalmology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Rong-Feng Liao
- Department of Ophthalmology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
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Lim H, Lee BJ, Kook MS, Sung KR, Kim KE, Moon Y. Topographic comparison of the retinal microvascular changes between patients with compressive and glaucomatous optic neuropathies. Sci Rep 2023; 13:22569. [PMID: 38114561 PMCID: PMC10730648 DOI: 10.1038/s41598-023-50068-6] [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: 07/08/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023] Open
Abstract
We investigated the difference in optical coherence tomography angiography characteristics between the patients with compressive optic neuropathy (CON, n = 26) and glaucomatous optic neuropathy (GON, n = 26), who were matched for the severity of visual field defect. The peripapillary retinal nerve fiber layer (pRNFL) thickness in the nasal and temporal sectors was thinner in the CON group, whereas the inferior pRNFL thickness was thinner in the GON group. Accordingly, the CON group had lower peripapillary vessel density (pVD) in the nasal and temporal sectors, and the GON group in the inferior sector. In the macular area, the CON group had a thinner macular ganglion cell-inner plexiform layer in the superior and nasal sectors, whereas the GON group in the inferior sector. However, the CON group did not have a lower macular VD than the GON group in any sector, whereas the GON group exhibited lower superficial capillary plexus VD in the superior, inferior, and temporal sectors. Comparison of the structure-vasculature correlation revealed a significant difference in the nasal and temporal peripapillary areas and superior and nasal macular sectors; a decrease in VD was greater in the GON group than in the CON group when the comparable structural change occurred.
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Affiliation(s)
- Hyunah Lim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Byung Joo Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Michael S Kook
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Kyung Rim Sung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Ko Eun Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Yeji Moon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Lei K, Tang Y, Pang R, Zhou H, Yang L, Wang N. Comparison of the retinal microvasculature between compressive and glaucomatous optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2023; 261:3589-3597. [PMID: 37347246 DOI: 10.1007/s00417-023-06137-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/16/2023] [Accepted: 06/01/2023] [Indexed: 06/23/2023] Open
Abstract
PURPOSE To compare the patterns of retinal microvasculature change in the peripapillary and macular region between compressive optic neuropathy (CON) and glaucomatous optic neuropathy (GON), and to assess the ability of optical coherence tomography angiography (OCTA) in differentiating the two conditions. METHODS This cross-sectional study included 108 participants (108 eyes), 36 with CON, 36 with GON, and 36 healthy controls. The CON and GON eyes were matched by the average peripapillary retinal nerve fiber layer (pRNFL) thickness (1:1). Optical coherence tomography (OCT) and OCTA were performed to compare the structural and vascular change of the peripapillary and macular region between groups. RESULTS Both CON and GON eyes showed more severe structural and vascular damage than the control eyes. The CON eyes had lower pRNFL thickness than the GON eyes in the temporal and nasal quadrants, and thicker pRNFL thickness in the inferior quadrant. The average GCC thickness did not differ between the two groups. The peripapillary vessel density of the CON group was significantly higher in the inferior sectors than that of the GON group. In the macular region, the CON group had significantly higher vessel density in the whole image, the temporal sector in parafovea region, and the temporal, superior, and inferior sectors in perifovea region. CONCLUSION To a similar degree of structural damage, CON had less retinal vascular impairment than GON, especially in the macular region, and the significance of the finding needs further evaluation.
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Affiliation(s)
- Kun Lei
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Yang Tang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ruiqi Pang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Huiying Zhou
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liu Yang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
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Ergen A, Kaya Ergen S, Gunduz B, Subasi S, Caklili M, Cabuk B, Anik I, Ceylan S. Retinal vascular and structural recovery analysis by optical coherence tomography angiography after endoscopic decompression in sellar/parasellar tumors. Sci Rep 2023; 13:14371. [PMID: 37658097 PMCID: PMC10474160 DOI: 10.1038/s41598-023-40956-2] [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: 04/04/2023] [Accepted: 08/19/2023] [Indexed: 09/03/2023] Open
Abstract
We assessed the potential retinal microcirculation alterations for postoperative visual recovery in sellar/paraseller tumor patients with Optical Coherence Tomography Angiography (OCT-A). Two hundred ten eyes with sellar/parasellar tumor for which preoperative and postoperative (3 months) MRI Scans, Visual Acuity Test, Optical Coherence Tomography (OCT), OCT-A and, Visual Field Test data were available, besides 92 healthy eyes were evaluated. In the preoperative phase, significant reductions were observed in retinal vascular densities in various regions, including the Superficial Retinal Capillary Plexus (SRCP) (whole: p < 0.001, fovea: p = 0.025, parafovea: p < 0.001), Deep Retinal Capillary Plexus (DRCP) (whole: p < 0.001, fovea: p = 0.003, parafovea: p < 0.001), Peripapillary Vascular Density (PVD) (whole: p = 0.045, peripapillary: p < 0.001, nasal: p < 0.001, inferior: p < 0.001, temporal: p < 0.001), and Retinal Nerve Fiber Layer (RNFL) (nasal: p = 0.024, inferior: p < 0.001, temporal: p < 0.001, superior: p < 0.001) compared to the healthy control group. After surgery, the postoperative data of patients without chiasmal distortion were compared to their preoperative data. In the postoperative evaluation, significant increases were observed in vascular densities in patients without chiasmal distortion in the SRCP (whole: p < 0.001, parafovea: p = 0.045), DRCP (whole: p = 0.007, fovea: p = 0.006, parafovea: p = 0.040), PVD (peripapillary: p = 0.010, inferior: p < 0.001, temporal: p < 0.001, superior: p < 0.001), and RNFL (nasal: p = 0.011, inferior: p = 0.034, temporal: p = 0.046, superior: p = 0.011). Furthermore, significant associations were observed in the ROC analysis between the postoperative Visual Field Mean Deviation (VFMD) and SRCP (whole AUC = 0.793, p < 0.001, cut-off = 51.45, parafovea AUC = 0.820, p < 0.001, cut-off = 53.95), DRCP (whole AUC = 0.818, p < 0.001, cut-off = 55.95, parafovea AUC = 0.820, p < 0.001, cut-off = 59.05), PVD (temporal AUC = 0.692, p < 0.001, cut-off = 55.10), and RNFL (whole AUC = 0.690, p = 0.001, cut-off = 119.5, inferior AUC = 0.712, p < 0.001, cut-off = 144.75). These findings indicate a potential role of pre and post-operative OCT-A measurements in the assessment of surgical timing and postoperative visual recovery in patients with or without optic chiasm distortion.
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Affiliation(s)
- Anil Ergen
- Department of Neurosurgery and Pituitary Research Center, School of Medicine, Kocaeli University, 41380, Kocaeli, Turkey
| | - Sebnem Kaya Ergen
- Department of Ophthalmology, Kocaeli Seka State Hospital, Kocaeli, Turkey
| | - Busra Gunduz
- Department of Neurosurgery and Pituitary Research Center, School of Medicine, Kocaeli University, 41380, Kocaeli, Turkey
| | - Sevgi Subasi
- Department of Ophthalmology, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Melih Caklili
- Department of Neurosurgery and Pituitary Research Center, School of Medicine, Kocaeli University, 41380, Kocaeli, Turkey
| | - Burak Cabuk
- Department of Neurosurgery and Pituitary Research Center, School of Medicine, Kocaeli University, 41380, Kocaeli, Turkey
| | - Ihsan Anik
- Department of Neurosurgery and Pituitary Research Center, School of Medicine, Kocaeli University, 41380, Kocaeli, Turkey
| | - Savas Ceylan
- Department of Neurosurgery and Pituitary Research Center, School of Medicine, Kocaeli University, 41380, Kocaeli, Turkey.
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Hepschke JL, Laws E, Bin Saliman NH, Juncu S, Courtie E, Belli A, Blanch RJ. Modifications in Macular Perfusion and Neuronal Loss After Acute Traumatic Brain Injury. Invest Ophthalmol Vis Sci 2023; 64:35. [PMID: 37115535 PMCID: PMC10150830 DOI: 10.1167/iovs.64.4.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Purpose Traumatic brain injury (TBI) causes structural damage and functional impairment in the visual system, often with retinal ganglion cell (RGC) degeneration occurring without visual symptoms. RGC degeneration is associated with reduced retinal blood-flow, however, it is not known whether reductions in perfusion precede or are secondary to neurodegeneration. Methods We conducted a prospective observational single-center case series. Patients were included if they were admitted to the hospital after acute TBI and underwent ophthalmic clinical examination, including optical coherence tomography (OCT) and OCT angiography (OCTA) acutely and at follow-up. Ganglion cell layer thickness (GCL) thickness, vascular density in the superficial vascular plexus (SVP), and intermediate capillary plexus (ICP) were quantified. Results Twenty-one patients aged 20 to 65 years (mean = 38 years) including 16 men and 5 women were examined less than 14 days after moderate to severe TBI, and again after 2 to 6 months. Macular structure and perfusion were normal at baseline in all patients. Visual function was abnormal at baseline in three patients and subsequent neurodegeneration and loss of perfusion corresponded to baseline visual function abnormalities. Nine patients (43%) had reduced macular GCL thickness at follow up. Perfusion in the SVP strongly associated with local GCL thickness. The strongest association of the SVP metrics was the sum of vessel density (P < 0.0001). Conclusions In cases of reduced visual function after TBI, macular perfusion remained normal until reductions in GCL thickness occurred, indicating that perfusion changes were secondary to local GCL loss.
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Affiliation(s)
- Jenny L Hepschke
- Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Elinor Laws
- Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- NIHR Surgical Reconstruction and Microbiology Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Noor H Bin Saliman
- Centre for Optometry Studies, Faculty of Health Sciences, Universiti Teknologi MARA Cawangan Selangor, Bandar Puncak Alam Selangor, Malaysia
| | - Stefana Juncu
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | - Ella Courtie
- Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- NIHR Surgical Reconstruction and Microbiology Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Antonio Belli
- Neurosurgery Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Richard J Blanch
- Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- NIHR Surgical Reconstruction and Microbiology Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, United Kingdom
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Lei K, Qu Y, Tang Y, Lu W, Zhao H, Wang M, Yang L, Zhang X. Discriminating Between Compressive Optic Neuropathy With Glaucoma-Like Cupping and Glaucomatous Optic Neuropathy Using OCT and OCTA. Transl Vis Sci Technol 2023; 12:11. [PMID: 36928131 PMCID: PMC10029766 DOI: 10.1167/tvst.12.3.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Purpose To discriminate between compressive optic neuropathy with glaucoma-like cupping (GL-CON) and glaucomatous optic neuropathy (GON) by comparing the peripapillary retinal nerve fiber layer (pRNFL) thickness and retinal microvasculature using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods In this retrospective cross-sectional study, OCT scans were performed on 28 eyes of GL-CON, 34 eyes of GON, and 41control eyes to determine the pRNFL thickness, ganglion cell complex thickness, and cup/disc ratio. OCTA scans were conducted for 12 eyes of GL-CON, 15 eyes of GON, and 15 control eyes to measure the vessel density of the peripapillary and macular areas. Analysis of covariance was used to perform the comparisons, and the area under the curve was calculated. Results The GON eyes had a significantly thinner pRNFL in the inferior quadrant and greater vertical cup/disc ratio than the GL-CON eyes. In the radial peripapillary capillary segment, the vessel density of the GON in the inferior sectors was significantly lower than in the GL-CON. The superficial macular vessel density in the whole-image, peritemporal, perinasal, and peri-inferior sectors was significantly smaller in the GON group than in the GL-CON group. The best parameter for discriminating between GL-CON and GON was the superficial macular vessel density in the peritemporal sector. Conclusions GL-CON eyes showed a characteristic pattern of pRNFL and retinal microvascular changes. Translational Relevance GL-CON can be effectively distinguished from GON by detecting the alterations in the pRNFL and retinal microvasculature using OCT and OCTA.
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Affiliation(s)
- Kun Lei
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuanzhen Qu
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yang Tang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen Lu
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Heng Zhao
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Meizi Wang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liu Yang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xuxiang Zhang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Banc A, Biousse V, Newman NJ, Kedar S. Ocular Optical Coherence Tomography in the Evaluation of Sellar and Parasellar Masses: A Review. Neurosurgery 2023; 92:42-67. [PMID: 36519859 PMCID: PMC10158913 DOI: 10.1227/neu.0000000000002186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/15/2022] [Indexed: 12/23/2022] Open
Abstract
Compression of the anterior visual pathways by sellar and parasellar masses can produce irreversible and devastating visual loss. Optical coherence tomography (OCT) is a noninvasive high-resolution ocular imaging modality routinely used in ophthalmology clinics for qualitative and quantitative analysis of optic nerve and retinal structures, including the retinal ganglion cells. By demonstrating structural loss of the retinal ganglion cells whose axons form the optic nerve before decussating in the optic chiasm, OCT imaging of the optic nerve and retina provides an excellent tool for detection and monitoring of compressive optic neuropathies and chiasmopathies due to sellar and parasellar masses. Recent studies have highlighted the role of OCT imaging in the diagnosis, follow-up, and prognostication of the visual outcomes in patients with chiasmal compression. OCT parameters of optic nerve and macular scans such as peripapillary retinal nerve fiber layer thickness and macular ganglion cell thickness are correlated with the degree of visual loss; additionally, OCT can detect clinically significant optic nerve and chiasmal compression before visual field loss is revealed on automated perimetry. Preoperative values of OCT optic nerve and macular parameters represent a prognostic tool for postoperative visual outcome. This review provides a qualitative analysis of the current applications of OCT imaging of the retina and optic nerve in patients with anterior visual pathway compression from sellar and parasellar masses. We also review the role of new technologies such as OCT-angiography, which could improve the prognostic ability of OCT to predict postoperative visual function.
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Affiliation(s)
- Ana Banc
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Ophthalmology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Valérie Biousse
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA;
| | - Nancy J. Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sachin Kedar
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA;
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA;
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Optical coherence tomographic angiography detects retinal vascular changes associated with pituitary adenoma. Am J Ophthalmol Case Rep 2022; 28:101711. [PMID: 36164560 PMCID: PMC9508429 DOI: 10.1016/j.ajoc.2022.101711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose Observations Conclusions and importance
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Akdogan M, Dogan M, Beysel S, Gobeka HH, Sabaner MC, Oran M. Optical coherence tomography angiography characteristics of the retinal and optic disc morphology in prolactinoma. Microvasc Res 2022; 144:104424. [PMID: 36007656 DOI: 10.1016/j.mvr.2022.104424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 07/01/2022] [Accepted: 08/19/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE To investigate changes in the retinal and optic disc (OD) morphology in prolactinoma patients without optical chiasmal compression and/or visual field defects using optical coherence tomography angiography (OCTA). METHODS In this cross-sectional imaging study, 16 consecutive prolactinoma patients (group 1, 32 eyes) and 15 age- and gender-matched healthy subjects (group 2, 30 eyes) underwent a thorough neuro-ophthalmological examination, which included testing for the presence of any intracranial compressive lesion that could cause optic neuropathy. Retinal morphological parameters, outer retinal and choriocapillaris flow areas, as well as OD vessel density (VD) and retinal nerve fiber layer (RNFL) thickness in for quadrants were then measured using OCTA. RESULTS Mean age (p = 0.537) and gender (p = 0.385) of participants in groups 1 and 2 did not differ significantly. The mean BCVA for both groups was 0.00 ± 0.00 logMAR. Microadenomas made up the majority of prolactinomas (87.1 %). All retinal morphological parameters in deep capillary plexus (excluding foveal VD) differed significantly between groups 1 and 2 (whole: p < 0.001, parafoveal: p = 0.021, and perifoveal: p < 0.001). Peripapillary RNFL thickness in temporal (p < 0.001), nasal (p = 0.010), and inferior (p = 0.007) quadrants also differed significantly between the two groups. Foveal deep (r = -0.304, p = 0.035) and choriocapillaris flow (r = -0.511, p = 0.008) were negatively correlated with tumor size at diagnosis. CONCLUSIONS Significant microvascular morphological changes, particularly in the deep retinal layer, as well as in the peripapillary RNFL thickness, were observed in prolactinoma patients. OCTA appears to be capable of detecting non-manifest circumpapillary and even intra-retinal microvascular changes even when there are no obvious signs of prolactinoma-related ocular complications caused by chiasmal compression.
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Affiliation(s)
- Mubera Akdogan
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, Turkey
| | - Mustafa Dogan
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, Turkey
| | - Selvihan Beysel
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Endocrinology and Metabolism, Afyonkarahisar, Turkey
| | - Hamidu Hamisi Gobeka
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, Turkey.
| | - Mehmet Cem Sabaner
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, Turkey
| | - Merve Oran
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, Turkey
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The use of optical coherence tomography angiography in patients with chiasmal compression (literature review). OPHTHALMOLOGY JOURNAL 2022. [DOI: 10.17816/ov105176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Optical coherence tomography (OCT) is currently the leading method for the observation and evaluation of microstructural changes in the retina in vivo. In recent years, OCT has been used in clinical practice to monitor the progression of compressive optic neuropathy in patients with chiasmal-sellar region neoplasms. The results obtained in the course of the studies opened up new opportunities for studying the pathogenesis of the development of compressive optic neuropathy in patients of this group. The advent of OCT-angiography (OCTA), developed on the basis of OCT, made it possible to study changes in the blood flow of the radial peripapillary capillary network, superficial and deep capillary plexuses, which opens up many opportunities for further research into the pathogenesis of visual impairment in this group of patients, prognosis of the development of the disease, and selection optimal terms of treatment. The literature review presents and analyzes the currently available results of the use of OCTA in patients with chiasmal compression.
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11
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Prognostic value of radial peripapillary capillary density for visual field outcomes in pituitary adenoma: A case-control study. J Clin Neurosci 2022; 100:113-119. [DOI: 10.1016/j.jocn.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/28/2022] [Accepted: 04/12/2022] [Indexed: 11/19/2022]
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Choroidal Thickness in Eyes with Band Atrophy of the Optic Nerve from Chiasmal Compression. J Ophthalmol 2022; 2022:5625803. [PMID: 35573812 PMCID: PMC9106526 DOI: 10.1155/2022/5625803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background The choroid is a vascular tissue that helps maintain retinal and prelaminar optic nerve head function. Choroidal thickness has been previously studied in diseases accompanied by retinal neural loss, but the relationship between the two sets of measurements is not clear. In eyes with temporal hemianopia as a result of chiasmal compression lesions (CCL), retinal neural loss tends to be greater in the nasal than the temporal hemiretina, a fact that may be useful in evaluating the effect of inner retinal layer loss on choroidal thickness. Purpose To evaluate macular and peripapillary choroidal thickness on swept-source optical coherence tomography (SS-OCT) in eyes with temporal hemianopia as a result of chiasmal compression and in healthy controls. Methods 33 eyes of 26 patients with band atrophy of the optic nerve and temporal visual field defects as a result of previously treated suprasellar tumors (CCL group) and 40 eyes of 21 healthy controls underwent SS-OCT scanning. The thickness of the peripapillary retinal nerve fiber layer (pRNFL), the peripapillary choroid (pChoroid), the macular RNFL (mRNFL), the macular ganglion cell layer (mGCL), and the macular choroid (mChoroid) was expressed globally and by sector (peripapillary quadrants and macular hemifield and quadrants). Ratios between macular nasal and temporal hemifield and quadrantic measurements were calculated using generalized estimated equation models, and the two groups were compared. Results The pRNFL, mRNFL, and mGCC thicknesses were significantly smaller in the CCL group than in the control group (64.67 ± 10.53 μm, 29.68 ± 5.80 μm, and 80.60 ± 10.17 μm vs. 103.78 ± 12.23 μm, 39.89 ± 3.82 μm, and 105.51 ± 7.76 μm, respectively; p < 0.001). For the choroid, the only difference between the groups was increased macular nasal hemifield and superonasal quadrant thickness in CCL (222.47 ± 61.05 μm and 230.45 ± 58.59 μm in the CCL group, respectively vs. 190.68 ± 52.54 μm and 197.65 ± 54.80 μm in the control group, respectively; p < 0.05). The temporal/nasal ratios were significantly higher for the mRNFL and mGCC parameters and significantly lower for the mChoroid parameters in the CCL group, except for the superotemporal/superonasal quadrant ratio. Conclusions The choroid does not thin after the inner retinal layer becomes damaged due to CCL and may even be thicker in some areas with corresponding severe retinal neural loss. While further studies are needed to interpret these findings, choroidal thinning is most likely not secondary to optic nerve disease-related inner retinal neural loss.
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Lee GI, Kim Y, Park KA, Oh SY, Kong DS, Hong SD. Parafoveal and peripapillary vessel density in pediatric and juvenile craniopharyngioma patients. Sci Rep 2022; 12:5355. [PMID: 35354881 PMCID: PMC8969166 DOI: 10.1038/s41598-022-09391-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 02/28/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractWe assessed the retinal microvascular alterations detected by optical coherence tomography angiography (OCT-A) in pediatric and juvenile craniopharyngioma (CP) patients with chiasmal compression. We included 15 eyes of 15 pediatric or juvenile CP patients and 18 eyes of 18 healthy subjects. The evaluation of vessel density from the superficial retinal capillary plexus (SRCP), the deep retinal capillary plexus, and the radial peripapillary capillary (RPC) segments was obtained by OCT-A. The association between vessel density measures and functional and structural measurements was also analyzed. There were significant reductions in the nasal sector of the SRCP (p < 0.0001) and all sectors of the RPC segment vessel density (nasal, temporal, and superior; p < 0.0001, inferior; p = 0.0015) in CP patients postoperatively compared to the healthy subjects. The peripapillary retinal nerve fiber layer (r = 0.6602, p = 0.0074) and ganglion cell-inner plexiform layer thicknesses (r = 0.7532, p = 0.0030) were associated with RPC segment vessel density. Visual acuity (r = − 0.5517, p = 0.0330) and temporal visual field sensitivity loss (r = 0.5394, p = 0.0465) showed an association with SRCP vessel density. In pediatric and juvenile patients with CP, parafoveal and peripapillary vascular changes following chiasmal compression were observed. The changes in vascular structures were closely related to structural and functional outcomes.
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Peripapillary Microvascularization Analysis Using Swept-Source Optical Coherence Tomography Angiography in Optic Chiasmal Compression. J Ophthalmol 2021; 2021:5531959. [PMID: 34527375 PMCID: PMC8437637 DOI: 10.1155/2021/5531959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the vessel density (VD) of the radial peripapillary capillary (RPC) network using swept-source optical coherence tomography angiography (SS-OCTA) “en face” images of eyes with chiasmal compression caused by brain tumors before and after decompressive surgery compared with healthy controls. Methods A cross-sectional study was conducted in 12 patients with chiasmal compression confirmed by neuroimaging. Sixteen healthy participants were also included. All patients with chiasmal compression underwent a neuro-ophthalmological examination one week before and 6 months after brain surgery, including static automated perimetry as well as measurement of the thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell complex (GCC) with spectral-domain optical coherence tomography (SD-OCT). Based on this neuro-ophthalmological examination, the presence of an optic neuropathy (ON) was evaluated. Peripapillary VD was obtained in four sectors on a 6 × 6 mm SS-OCTA image using the Cirrus Plex Elite 9000. Results Baseline average VD was significantly lower in patients with chiasmal compression and ON than in controls (median: 55.62; interquartile range (IQR): 2.96 vs. 58.53; IQR: 2.02; p=0.003). This decrease was also found in the temporal, superior, and nasal sectors. Average postoperative VD was decreased in patients with chiasmal compression compared with average preoperative VD (median: 56.16; IQR: 4.07 vs. 57.48; IQR: 3.83; p=0.004). Preoperative VD was significantly correlated with RNFL, GCC thickness, and visual field defects. Conclusions The VD of the RPC network was decreased in chiasmal compressive ON, and it was further decreased at 6 months after decompressive surgery.
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Changes of Peripapillary Region Perfusion in Patients with Chiasmal Compression Caused by Sellar Region Mass. J Ophthalmol 2021; 2021:5588077. [PMID: 34221493 PMCID: PMC8219428 DOI: 10.1155/2021/5588077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/04/2021] [Indexed: 01/15/2023] Open
Abstract
Purpose To evaluate the peripapillary vessel density (pVD) and the peripapillary nerve fiber layer (pRNFL) thickness in patients with chiasmal compression caused by sellar region mass using optical coherence tomography angiography (OCTA). Methods This is an observational, cross-sectional study of 31 patients (31 eyes) with chiasmal compression caused by sellar region mass and 34 healthy controls (34 eyes). Automated perimetry and OCTA were performed. The pVD and pRNFL thickness were compared between the two groups. The impact of tumor diameter, duration of symptoms, and cavernous sinus (CS) invasion on visual dysfunction, pVD, and pRNFL thickness was also analyzed. Furthermore, we divided the patients into two subgroups according to whether there was an absolute defect in the central visual field and evaluated their pVD and pRNFL thickness, respectively. Results Compared to the healthy control group, there was a statistically significant decrease in pVD and pRNFL thickness in patients with chiasmal compression (p < 0.05), especially in patients with substantial absolute defects in the central visual field. Tumor diameter, duration of symptoms, and CS invasion did not appear to be associated with pVD and pRNFL thickness. There was a significant positive correlation between the pVD and pRNFL thickness in patients with chiasmal compression (p < 0.001). Conclusion pVD and pRNFL thickness are significantly decreased in patients with chiasmal compression revealed by OCTA, especially in patients with more severe visual field defects. A significant correlation between pVD and pRNFL thickness was demonstrated, which provides a clue for the study of the mechanism of changes in retinal perfusion in compressive optic neuropathy. It requires considerable attention that OCTA may play an important role in disease monitoring of sellar region mass. Hence, further studies are needed to verify whether OCTA is helpful to predict the prognosis of visual function after decompression surgery.
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Lee GI, Park KA, Oh SY, Kong DS. Changes in parafoveal and peripapillary perfusion after decompression surgery in chiasmal compression due to pituitary tumors. Sci Rep 2021; 11:3464. [PMID: 33568736 PMCID: PMC7876027 DOI: 10.1038/s41598-021-82151-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 12/21/2020] [Indexed: 11/24/2022] Open
Abstract
We evaluated changes in parafoveal and peripapillary vessel density in chiasmal compression after decompression surgery using optical coherence tomography angiography (OCT-A). Sixty-two eyes with chiasmal compression for which preoperative and postoperative (4–6 months) OCT, OCT-A, visual field (VF), and comprehensive ophthalmic data were available, and 44 healthy eyes were evaluated. Vessel densities of the superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment were assessed using OCT-A. The postoperative measurements were compared with preoperative data. Preoperative peripapillary retinal nerve fiber layer, macular ganglion cell-inner plexiform layer thickness, and vessel densities of SRCP and RPC segments in patients’ eyes were significantly reduced compared to those of healthy controls (P < 0.0001, P < 0.0001, P = 0.0052, and P = 0.0085, respectively). Vessel densities were significantly decreased in the SRCP (P < 0.0001), DRCP (P = 0.0017), and RPC segments (P < 0.0001) after surgery compared to the preoperative values. Significant associations between the postoperative SRCP and DRCP vessel density changes and preoperative SRCP (r = − 0.3195, P = 0.0114) and DRCP (r = − 0.5165, P < 0.0001) vessel densities were found, respectively. There were also significant associations between postoperative SRCP vessel density changes and VF changes (r = − 0.2586, P = 0.0424). These findings indicate that decreased perfusion around the optic nerve head and on the macula associated with chiasmal compression could further progress after decompression surgery. Further functional and longer-term clinical studies are needed to elucidate the clinical implications of these findings.
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Affiliation(s)
- Ga-In Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Doo-Sik Kong
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Courtie E, Veenith T, Logan A, Denniston AK, Blanch RJ. Retinal blood flow in critical illness and systemic disease: a review. Ann Intensive Care 2020; 10:152. [PMID: 33184724 PMCID: PMC7661622 DOI: 10.1186/s13613-020-00768-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Assessment and maintenance of end-organ perfusion are key to resuscitation in critical illness, although there are limited direct methods or proxy measures to assess cerebral perfusion. Novel non-invasive methods of monitoring microcirculation in critically ill patients offer the potential for real-time updates to improve patient outcomes. MAIN BODY Parallel mechanisms autoregulate retinal and cerebral microcirculation to maintain blood flow to meet metabolic demands across a range of perfusion pressures. Cerebral blood flow (CBF) is reduced and autoregulation impaired in sepsis, but current methods to image CBF do not reproducibly assess the microcirculation. Peripheral microcirculatory blood flow may be imaged in sublingual and conjunctival mucosa and is impaired in sepsis. Retinal microcirculation can be directly imaged by optical coherence tomography angiography (OCTA) during perfusion-deficit states such as sepsis, and other systemic haemodynamic disturbances such as acute coronary syndrome, and systemic inflammatory conditions such as inflammatory bowel disease. CONCLUSION Monitoring microcirculatory flow offers the potential to enhance monitoring in the care of critically ill patients, and imaging retinal blood flow during critical illness offers a potential biomarker for cerebral microcirculatory perfusion.
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Affiliation(s)
- E Courtie
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - T Veenith
- Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - A Logan
- Axolotl Consulting Ltd, Droitwich, WR9 0JS, Worcestershire, UK
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7HL, UK
| | - A K Denniston
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- Centre for Rare Diseases, Institute of Translational Medicine, Birmingham Health Partners, Birmingham, UK
| | - R J Blanch
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
- Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
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