Speed-Spatial Frequency-Contrast test, a novel vision test to predict the outcome of optic canal decompression for indirect traumatic optic neuropathy patients with pre-operative no light perception

Abstract

Purpose : Endoscopic trans-ethmosphenoid optic canal decompression surgery has become an optimal treatment option for patients with indirect traumatic optic neuropathy. However, there is currently no reliable method to predict the outcome of this surgery for patients with no light perception. This study aims to design and verify a novel vision test, speed-spatial frequency-contrast test, to predict the outcome of decompression surgery for indirect traumatic optic neuropathy.

Methods : Seventy-two indirect traumatic optic neuropathy patients with pre-operative no light perception who underwent the surgery in Zhongshan Ophthalmic Center from January 2020 to December 2021 were recruited. Speed-spatial frequency-contrast test, visual acuity, visual evoked potential, retinal vascular oxygen saturation, retinal thickness and vessel density were recorded before the surgery and 3 months after. The sensitivity and specificity of speed-spatial frequency-contrast test was verified by the outcomes of these no light perception patients after the surgery.

Results : The sensitivity and specificity of speed-spatial frequency-contrast test was 74.3% (26/35) and 94.6% (35/37), respectively. The area under curve was 0.869 (95% CI: 0.780-0.959). The pre-operative speed-spatial frequency-contrast score was associated with the level of post-operative vision improvement. Positive speed-spatial frequency-contrast test was associated with better visual evoked potential improvement, greater elevation of the retinal oxygen saturation, thicker retinas and greater vessel density.

Conclusions : SSC test was a valid, feasible and simple predictive program of surgical effectiveness for no light perception patients with promising sensitivity and specificity.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.