Invited Commentary: Ganglion Cell Complex Measurement in Compressive Optic Neuropathy

Occasionally, I'm asked by a patient right before surgery, 'will my vision recover after my tumor is removed'? The crucial predictor is the appearance of the optic discs. Recovery of function correlates with the amount of optic atrophy (1-4). This can be gauged so easily by fundus examination that I seldom bother with optical coherence tomography (OCT). Yet, OCT examination of the inner retina seems to fascinate neuro-ophthalmologists. No less than 27 studies have shown that reduction of the retinal nerve fiber layer (RNFL) is correlated with visual field loss and augers a worse outcome following chiasm decompression (5). Given that ganglion cell axons convey the output of the retina to the brain, such observations are hardly surprising.