Physiological Correlates and Predictors of Functional Recovery After Chiasmal Decompression

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Title Physiological Correlates and Predictors of Functional Recovery After Chiasmal Decompression
Creator Noa Raz, PhD; Atira S. Bick, PhD; Alexander Klistorner, PhD; Sergey Spektor, MD, PhD; Daniel S. Reich, MD, PhD; Tamir Ben-Hur, MD, PhD; Netta Levin, MD, PhD
Affiliation Departments of Ophthalmology (JM, CO, MD), Radiology (AJT), and Neurology (MD), Weill Cornell Medical College, New York, New York
Abstract The goal of our study was to look for the presence of homonymous ganglion cell layer-inner plexiform layer complex (GCL-IPL) thinning using spectral-domain optical coherence tomography (SD-OCT) in patients with a history of adult-onset injury to the postgeniculate pathways with rigorous radiological exclusion of geniculate and pregeniculate pathology. We performed a retrospective review of twenty-two patients (ages 24-75 y, 6 men, 16 women) with homonymous visual field (VF) defects secondary to postgeniculate injury examining the GCL-IPL with SD-OCT. An additional fifteen patients (ages 28-85 y, 5 men, 10 women) with no visual pathway pathology served as controls. Using segmentation analysis software applied to the macular scan, a normalized asymmetry score was calculated for each eye comparing GCL-IPL thickness ipsilateral vs contralateral to the patient's brain lesions. We found that 15 of the twenty-two subjects had a relative thinning of the GCL-IPL ipsilateral to the postgeniculate lesion in both eyes (represented by a positive normalized asymmetry score in both eyes), whereas a similar pattern of right/left asymmetry was found in 4 controls (P = 0.0498). The magnitude of asymmetry was much greater in subjects compared with controls (P = 0.0004). There was no association between the degree of GCL-IPL thinning and the mean deviation on automated VF testing. A moderate correlation (R = 0.782, P = 0.004) between the magnitude of thinning and latency from onset of retrogeniculate injury was observed only after excluding patients beyond a cutoff point of 150 months. This data provides compelling new evidence of retrograde transsynaptic degeneration causing retinal ganglion cell loss after postgeniculate visual pathway injury.
Subject Adolescent; Adult; Decompression, Surgical; Diffusion Magnetic Resonance Imaging; Evoked Potentials, Visual; Humans; Longitudinal Studies; Male; Meningeal Neoplasms; Meningioma; Middle Older people; Nerve Fibers; Optic Chiasm; Optic Nerve Diseases; Recovery of Function; Retina; Tomography, Optical Coherence; Treatment Outcome; Visual Fields; Young Adult
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Date 2015-12
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s66x35j2
Setname ehsl_novel_jno
ID 1276420
Reference URL https://collections.lib.utah.edu/ark:/87278/s66x35j2
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