Abstract
The aims of this study are to compare optical coherence tomography (OCT)-measured macular retinal layers in eyes with permanent temporal hemianopia from chiasmal compression and control eyes; to compare regular and slow-flash multifocal electroretinography (mfERG) in patients and controls; and to assess the correlation between OCT, mfERG, and central visual field (SAP) data. Forty-three eyes of 30 patients with permanent temporal hemianopia due to pituitary tumors who were previously submitted to chiasm decompression and 37 healthy eyes of 19 controls were submitted to macular spectral domain OCT, mfERG, and 10-2 SAP testing. After segmentation, the thickness of the macular retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer, and photoreceptor layer (PRL) was measured. Amplitudes and oscillatory potentials (OPs) were measured on regular and slow-flash mfERG, respectively, and expressed as the mean values per quadrant and hemifield. RNFL, GCL, and IPL thickness measurements were significantly reduced in all quadrants, whereas INL, OPL, and PRL thicknesses were significantly increased in the nasal quadrants in patients compared to those in controls. Significant correlations between OCT and 10-2 SAP measurements were positive for the RNFL, GCL, and IPL and negative for the INL, OPL, and PRL. OPs and mfERG N1 amplitudes were significantly reduced in the nasal hemiretina of patients. Significant correlations were found between OP and mfERG amplitudes for inner and outer nasal hemiretina OCT measurements, respectively. Patients with permanent temporal hemianopia from previously treated chiasmal compression demonstrated significant thinning of the RNFL, GCL, IPL, and thickening of the INL, OPL, and PRL associated with reduced OP and mfERG N1 amplitudes, suggesting that axonal injury to the inner retina leads to secondary damage to the outer retina in this condition.
Highlights
Optical coherence tomography (OCT) has become a valuable tool in the workup of patients with retinal diseases and in the quantification of retinal neural loss in patients with optic pathway diseases
Damage to the retinal ganglion cell (RGC) and retinal nerve fibers originating in the temporal hemiretina occurred before chiasmal decompression, and the nasal visual field (VF) was labeled as being within normal limits at the time of the study, some subclinical damage already existed in the temporal retina
The model seems valid for the main purpose of the current study that was to investigate structural and functional changes in retinal layers other than the retinal nerve fiber layer (RNFL) and the ganglion cell layer (GCL) in patients with temporal hemianopia from previous chiasmal compression
Summary
Optical coherence tomography (OCT) has become a valuable tool in the workup of patients with retinal diseases and in the quantification of retinal neural loss in patients with optic pathway diseases. Increased thickness and microcystic abnormalities in the inner nuclear layer (INL) were first noticed in MS and NMO [14,15,16,17,18] and later in other optic neuropathies [19,20,21], in chiasmal compression [22], and in optic tract lesion [23]. The observation of secondary INL abnormalities in eyes with anterior visual pathway lesions increases the likelihood of finding abnormalities in the outer retinal layers as well. These layers can be measured separately with spectral domain OCT (SD-OCT) technology
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