Correlation Between Fourier-Domain Optical Coherence Tomography Measurements of the Macular and Retinal Nerve Fiber Layer and Visual Field Sensitivity Loss in Patients With Chiasmal Compression

Abstract

Purpose: : To test the correlation between fourier-domain (FD) optical coherence tomography (OCT) measurements of the macular and retinal nerve fiber layer (RNFL) and visual field sensitivity (VFS) loss on standard automated perimetry (SAP) in eyes with permanent temporal hemianopia from chiasmal compression.

Methods: : 35 patients with permanent temporal visual field (VF) defects and 35 age- and sex-matched healthy subjects. One eye of each subject was studied.Subjects underwent SAP (Humphrey) and macular and RNFL thickness measurements with the commercially available 3D OCT-1000^® (Topcon). Macular thickness measurements were recorded and averaged for the central area and for each quadrant and half of that area, while RNFL thickness was measured and averaged for each sector around the optic disc. VFS loss was estimated from the temporal mean defect (the average of the 22 values of the temporal total deviation plot on the SAP 24-2 test, excluding the 2 points immediately above and below the blind spot), from the deviations from normal in six sectors and from the central 16 test points in the VF.

Results: : Global and sectoral macular and RNFL thickness parameters differed significantly between eyes with BA and healthy controls. Correlations were stronger between VFS loss and quadrantic or hemianopic nasal macular thickness than between VFS loss and sectoral RNFL thickness. The strongest correlation was observed between macular thickness in the inferonasal quadrant and VFS loss in the superior temporal central quadrant (ρ=0.78; R²=61%; p<0.001).

Conclusions: : RNFL and macular thickness measured with FD-OCT were both topographically correlated with VFS loss in patients with temporal hemianopia from chiasmal compression. The correlation was stronger with quadrantic macular measurements than with RNFL thickness measurements. Macular thickness measurements could potentially be used to quantify neuronal loss in patients with chiasmal compression and could prove clinically useful in the detection of damage and follow-up of these patients.

Clinical Trial: : www.clinicaltrials.gov NCT00607100

Keywords: neuro-ophthalmology: optic nerve • nerve fiber layer • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)