Objective: To evaluate patterns of macular retinal ganglion cell complex thickness (mRGCCT) in patients with two types of neurologic lesions in optic chiasm region.
Methods: Retrospective case review study. Visual field test was conducted with automated perimetry (HAAG-STREIT OCTOPUS101 V6.07g Seven-in-One and 2010(HFA Ⅱ750-40220-5.1.1/5.1.1) Carl Zeiss Meditec), and visual field in the central 30 degree region was measured. Three types of thickness mapping including macular retinal thickness (MRT), macular ganglion cell complex thickness (mGCCT) and peripapillary retinal nerve fiber layer (pRNFL) were recorded with TOPCON 3D-OCT 2000 spectral domain OCT. The results of OCT were compared with visual field.
Results: Sixteen cases were included in this study, male 10 cases, female 6 cases. Age 5 to 77 years (average 48.2). Neurologic lesions including pituitary tumor (9 cases), craniopharyngioma (3 cases), optic canal dysplasia in optic chiasm region (1 case), meningioma (1 case), hemangioma (1 case) and aneurysm (1 case). 14 cases have chronic, progressive, long course of disease, OCT showed characteristic perpendicular bisector delimitation, bilateral nasal mGCCT atrophy and corresponding temporal hemianopsia. 2 cases (both were pituitary tumor ) have a chronic, short duration, accelerated attack, visual acuity and visual field rapidly declined, mGCCT is swelling or approach high limit of normal range. In pRNFL thickness map, atrophy of mRNFL in temporal peripapillary and nasal macular region could be observed.
Conclusions: Chronic, progressive, long course of disease, combined with characteristic perpendicular bisector delimitation, bilateral nasal mGCCT atrophy and corresponding temporal hemianopsia is helpful to predict lesion of disease. mGCCT map is of equal importance with visual field test for diagnosis of lesion within optic chiasm. In cases with a chronic, short disease course, and accelerated attack, mGCCT could be swelling, but pRNFL could be thinner in temporal peripapillary and nasal macular region of single or both eyes, and visual field test is thus necessary in these cases.