Role of Optical Coherence Tomography in Predicting Visual Outcome after Surgery for Sellar and Supra-Sellar Tumors.

Journal: Neurology India

Volume: 72

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India. Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India. Department of Ophthalmology, Aster CMI Hospital, Bengaluru, Karnataka, India. Department of Neuroimaging and Interventional Radiology (NIIR), National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Abstract summary 

Almost one-fifth of patients undergoing surgery for sellar/supra-sellar tumors do not gain a significant improvement in their vision. Various methods have been described to predict prospective visual outcomes in them, although they lack uniformity.The study was conducted to predict visual outcomes following surgery for sellar and supra-sellar tumors compressing the anterior optic pathway based on pre-operative optical coherence tomography (OCT) parameters.This was a record-based observational descriptive longitudinal study done in a tertiary care center in India. Thirty-seven patients (74 eyes) diagnosed with sellar supra-sellar lesions were included in the study. Patients' ophthalmic evaluations, done pre-operatively and 3 months post-operatively, were reviewed. Spectral-domain OCT and segmentation were done using the automated segmentation technology of Spectralis software. The thickness of the respective layers was measured.The mean age of the study population was 42.68 years. Eyes with a pre-operative visual acuity component of VIS (visual impairment score) ≤61, pre-operative ganglion cell layer thickness ≥26.31 um, a pre-operative inner plexiform layer thickness of ≥25.69 um, a pre-operative ganglion cell inner plexiform layer thickness of 52.00 um, pre-operative ganglion cell complex thickness ≥84.47 μm, and a pre-operative inner retinal layer thickness of ≥205.25 μm were more likely to have an improved visual outcome. Eyes with a pre-operative duration of visual symptoms of ≥15 months, VIS ≥126.50, a pre-operative decimal visual acuity of <0.035, a pre-operative visual field index of ≤8%, a pre-operative macular thickness of ≤287.06 um, a pre-operative macular RNFL (retinal nerve fiber layer) thickness ≤66.00 μm, and a pre-operative peri-papillary RNFL thickness ≤64.62 μm were unlikely to have visual improvement.

Authors & Co-authors:  Singha Beniwal Mailankody Battu Saini Tyagi Srinivas

Study Outcome 

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Citations :  Müller-Forell W. Intracranial pathology of the visual pathway. Eur J Radiol 2004;49:143–78
Authors :  7
Identifiers
Doi : 10.4103/neurol-india.Neurol-India-D-23-00654
SSN : 1998-4022
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Study Design
Longitudinal Study
Study Approach
Country of Study
Publication Country
India