Helen Danesh-Meyer1,2, R C Andrew Symons3,1,4,5,6, Joos Meyer7, Ibrahima Diouf8, James King1,9, Kate Drummond1,9, Stan Stylli1,9, Andrew Kaye9,10, Tomas Kalincik8,11. 1. Department of Surgery, The University of Melbourne, Parkville, VIC, Australia. 2. Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand. 3. Ophthalmology Department, The Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia. 4. Centre For Eye Research Australia, Level 7/32 Gisborne St, East Melbourne, VIC, 3002, Australia. 5. Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia. 6. Department of Surgery, Monash Medical Centre Level 5, Monash University, Block E 246 Clayton Road, Clayton, 3168, Australia. 7. Ophthalmology Department, The Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia. joos.meyer@gmail.com. 8. CORe, Department of Medicine, University of Melbourne, Melbourne, Australia. 9. Neurosurgery Department, The Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia. 10. Department of Neurosurgery, Hadassah Hebrew University Medical Centre, Jerusalem, Israel. 11. Department of Neurology, MS Centre, The Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia.
Abstract
PURPOSE: The prognostic value of optical coherence tomography (OCT) of the macular ganglion cell layer (mGGL) versus peripapillary retinal nerve fibre layers (pRNFL) following chiasmal decompression is unclear. This study is the largest comparison of the two parameters to date and aims to clarify how their performance as covariates compare in predictive models of long-term visual outcomes following pituitary or parasellar tumour surgical resection. METHODS: This was a prospective, two-year, longitudinal cohort study in a single centre tertiary hospital setting. Participants with MRI evidence of pituitary or parasellar tumour compression of the optic chiasm who underwent surgical decompression, were enrolled. Associations between pre-operative OCT parameters and long-term visual outcomes were assessed using multivariable generalised linear mixed models and an age matched normative database. RESULTS: Final analysis included 216 eyes of 108 participants with a mean age (standard deviation) of 51.6 (17.04) years, of whom 58 (49%) were female. The superior inner mGCL was the best predictor of long-term visual field recovery, with an area under the curve of 0.90, a sensitivity of 80%, specificity of 88%, positive predictive value of 86%, and negative predictive value of 83%. CONCLUSION: mGCL performed better in predicting long-term visual field recovery post-pituitary or parasellar surgical resection. The superior inner mGCL was the best specific measure which may provide clinical utility in pre-operative counselling. In this study we clarify previously variable comparisons of mGCL and pRNFL parameters in post-operative predictive modelling.
PURPOSE: The prognostic value of optical coherence tomography (OCT) of the macular ganglion cell layer (mGGL) versus peripapillary retinal nerve fibre layers (pRNFL) following chiasmal decompression is unclear. This study is the largest comparison of the two parameters to date and aims to clarify how their performance as covariates compare in predictive models of long-term visual outcomes following pituitary or parasellar tumour surgical resection. METHODS: This was a prospective, two-year, longitudinal cohort study in a single centre tertiary hospital setting. Participants with MRI evidence of pituitary or parasellar tumour compression of the optic chiasm who underwent surgical decompression, were enrolled. Associations between pre-operative OCT parameters and long-term visual outcomes were assessed using multivariable generalised linear mixed models and an age matched normative database. RESULTS: Final analysis included 216 eyes of 108 participants with a mean age (standard deviation) of 51.6 (17.04) years, of whom 58 (49%) were female. The superior inner mGCL was the best predictor of long-term visual field recovery, with an area under the curve of 0.90, a sensitivity of 80%, specificity of 88%, positive predictive value of 86%, and negative predictive value of 83%. CONCLUSION: mGCL performed better in predicting long-term visual field recovery post-pituitary or parasellar surgical resection. The superior inner mGCL was the best specific measure which may provide clinical utility in pre-operative counselling. In this study we clarify previously variable comparisons of mGCL and pRNFL parameters in post-operative predictive modelling.
Authors: Yingying Shi; Qinqin Zhang; Hao Zhou; Liang Wang; Zhongdi Chu; Xiaoshuang Jiang; Mengxi Shen; Marie Thulliez; Cancan Lyu; William Feuer; Luis de Sisternes; Mary K Durbin; Giovanni Gregori; Ruikang K Wang; Philip J Rosenfeld Journal: Am J Ophthalmol Date: 2020-12-24 Impact factor: 5.258