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 Raz, Noa; Bick, Atira S; Klistorner, Alexander; Spektor, Sergey; Reich, Daniel S; Ben-Hur, Tamir; Levin, Netta
Affiliation Departments of Ophthalmology (JM, CO, MD), Radiology (AJT), and Neurology (MD), Weill Cornell Medical College, New York, New York
Subject Adolescent; Adult; Decompression, Surgical; Diffusion Magnetic Resonance Imaging; Evoked Potentials, Visual; Humans; Longitudinal Studies; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Nerve Fibers; Optic Chiasm; Optic Nerve Diseases; Recovery of Function; Retina; Tomography, Optical Coherence; Treatment Outcome; Visual Fields; Young Adult
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.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2015-12
Type Text
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s66x35j2
Setname ehsl_novel_jno
Date Created 2017-09-14
Date Modified 2017-09-14
ID 1276420
Reference URL
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