Professor and Head DEPARTMENT OF NEUROSURGERY,NIMHANS Bangalore, India
Introduction: The study was conducted to predict visual outcome following surgery for Sellar and Supra-sellar tumors compressing anterior optic pathway based on pre-operative Optical Coherence Tomography (OCT) parameters.
Methods: 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’ clinical details were accessed from the hospital medical records. Patients’ ophthalmic evaluations, done preoperatively and 3 months post-operatively, were reviewed. Spectral-domain OCT and segmentation was done using Automated segmentation technology of Spectralis software. The thickness of the respective layers was measured. Results were tabulated and analyzed. Data were analyzed using R software version 3.5.2
Results: Eyes with pre-operative Visual Acuity component of VIS (Visual impairment score) ≤ 61, pre-operative GCL thickness ≥26.31 um, pre-operative IPL thickness of ≥25.69 um, pre-operative GC-IPL (Ganglion cell Inner plexiform layer) thickness of 52.00 um, pre-operative ganglion cell complex thickness ≥84.47 μm, and pre-operative IRL (Inner retinal layer) thickness of ≥205.25 μm were more likely to have an improved visual outcome. Eyes with Pre-operative Duration of visual symptoms of ≥15 months, Visual Impairment Score ≥126.50, Pre-operative decimal visual acuity of < 0.035, Pre-Operative Visual field index of ≤8%, Pre-Operative Macular Thickness of ≤287.06 um, Pre-operative Macular RNFL thickness ≤66.00 μm and pre-operative peri-papillary RNFL (Retinal nerve fiber layer) thickness ≤ 64.62 μm, were unlikely to have visual improvement.
Conclusion : Based on preoperative visual function, peri-papillary RNFL thickness and various macular OCT parameters post-operative visual outcome of sellar-suprasellar lesions can be predicted.
