Functional Prognostic value of optical coherence tomography in optic chiasmal decompression: A preliminary study.

Summary Purpose To assess the predictive value for functional recovery of Ganglion Cell Complex Layer (GCC) and Retinal Nerve Fiber Layer (RNFL) measurements obtained by Optical Coherence Tomography (OCT) in patients undergoing chiasmal decompression and to define potential OCT thresholds for visual recovery. Methods We measured preoperative GCC and RNFL thickness in patients with a sellar and/or perisellar tumor compressing the optic chiasm. Visual recovery was defined as recovery of mean deviation (MD) and pattern standard deviation (PSD) using Humphrey visual field testing after 12 successful decompressions (24 eyes). Receiver operating characteristic curve (ROC) analysis was used to identify the best thresholds. Results Robust global and focal OCT thresholds were found. Superior GCC ≥ 63 μm had the best functional prognostic value (AUC = 1) for visual improvement. Mean GCC ≥ 67 μm and mean RNFL ≥ 75 μm also had excellent predictive values (AUC > 0.9). Conclusion In this preliminary study, significant preoperative OCT thresholds for early visual recovery after chiasmal decompression were identified, mainly regarding GCC measurements. Further studies on larger cohorts with closely scheduled follow-up could refine our results.