Abstract
The aim of this study was to evaluate the predictive role of preoperative retinal nerve fiber layer (RNFL) thickness for postoperative visual recovery in patients with chiasmal compression through performing a meta-analysis. PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure were searched for relevant studies. The study and patient characteristics were extracted. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to estimate the predictive value of RNFL thickness. Subgroup analyses were also performed. Four studies with 202 patients and 395 eyes were included. The pooled results showed that patients with normal RNFL thickness could achieve better visual recovery compared with those with thin RNFL with the OR of 15.61 (95% CI, 4.09-59.61). Significant heterogeneity was observed (I2 = 54.5%, P=0.086). Publication bias was not present. Normal preoperative RNFL thickness could predict better postoperative visual recovery than thin RNFL in patients with chiasmal compression.
Highlights
Sellar and parasellar region lesions, such as pituitary adenoma, cystic lesions, craniopharyngioma and meningioma, always lead to the compression of optic chiasm [1,2,3]
The pooled results showed that patients with normal retinal nerve fiber layer (RNFL) thickness could achieve better visual recovery compared with those with thin RNFL with the odds ratio (OR) of 15.61
This study aimed to investigate the predictive value of RNFL thickness for visual recovery in patients with chiasmal compression
Summary
Sellar and parasellar region lesions, such as pituitary adenoma, cystic lesions, craniopharyngioma and meningioma, always lead to the compression of optic chiasm [1,2,3]. Pituitary adenoma, which accounts for 12–15% of all intracranial lesions, is the most common [4]. Visual impairment, including visual field (VF) defects and loss of visual acuity (VA), is a common complaint in these patients [3, 5]. Some patients could gain an appreciable visual recovery after surgical decompression, a great number of them could not [6]. Many researchers have investigated potential predictive factors, and variables such as age, size of tumor, preoperative visual impairment, preoperative duration of symptoms and optic atrophy were suggested [7,8,9]. Conflicting results still remain, and none of them were regarded as reliable predictors for visual recovery [10, 11]
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