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.
Highlights
We evaluated changes in parafoveal and peripapillary vessel density in chiasmal compression after decompression surgery using optical coherence tomography angiography (OCT-A)
One longitudinal study reported that the Retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) area in patients with chiasmal compression were significantly reduced after three months postoperatively, while significant improvements in visual field (VF) defects were observed after s urgery[2]
We found that lower postoperative vessel density in the superficial retinal capillary plexus (SRCP) was associated with worse postoperative visual acuity (r = − 0.2980, P = 0.0187), and lower postoperative vessel density in the radial peripapillary capillary (RPC) segment was associated with worse postoperative VF (r = 0.4804, P = 0.0001) and visual acuity (r = − 0.2705, P = 0.0335) (Table 4)
Summary
We evaluated changes in parafoveal and peripapillary vessel density in chiasmal compression after decompression surgery using optical coherence tomography angiography (OCT-A). 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). There were 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. Retinal nerve fiber layer (RNFL)[1,2] and ganglion cell complex (GCC)[3] thinning on optical coherence tomography (OCT) in chiasmal compression have been reported in many previous studies The thinning of these layers in eyes with hemianopsia due to chiasmal compression can persist after s urgery[4,5,6]. The purpose of this study was to investigate changes in the preoperative and postoperative vessel density values in eyes with chiasmal compression using OCT-A
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