Outer Retinal Assessment of Patients with Temporal Hemianopia from Chiasmal Compression Using Spectral-Domain Optical Coherence Tomography

Patients with chiasmal compression from pituitary tumors have retinal nerve fiber layer and ganglion cell layer thinning that are correlated with visual field (VF) defects. Few studies have evaluated the outer retinal layers in these patients, with contradicting conclusions. The purpose of this study is to investigate outer retinal parameters in patients with pituitary tumors and VF loss.

287 Outer Retinal Assessment Of Patients With Temporal Hemianopia from Chiasmal Compression Using Spectral-Domain Optical Coherence Tomography Caroline Awh 1, Sonia Kim 2, Karen Matar 1, Lisa Lystad 1, Justis Ehlers 1, Ang Li 1 1 Cole Eye Institute, 2 Case Western University Introduction: Patients with chiasmal compression from pituitary tumors have retinal nerve fiber layer and ganglion cell layer thinning that are correlated with visual field (VF) defects. Few studies have evaluated the outer retinal layers in these patients, with contradicting conclusions. The purpose of this study is to investigate outer retinal parameters in patients with pituitary tumors and VF loss. Methods: In this retrospective cross-sectional study, 20 eyes of 10 patients with temporal hemianopia due to pituitary tumors and 20 healthy control eyes were included for analysis. All patients underwent VF and spectral-domain OCT testing prior to resection of the tumor. OCT scans were segmented using a machine learning-enabled platform with manual correction. Output metrics included thickness of the inner retina (internal limiting membrane to outer plexiform layer), middle retina (outer nuclear layer [ONL] to ellipsoid zone), outer retina (ONL to retinal pigment epithelium), and photoreceptor outer segment (OS). These layers were further segmented into nasal and temporal hemiretinas. Results: The inner retina (p=0.005) and middle retina (p=0.028) were statistically significantly thinner in patient eyes compared to control eyes. There was no significant difference between the outer retinal thickness of the 2 groups; however, when isolating the nasal outer retina, the patient group was found to be significantly thinner (p=0.007). This difference was not seen in the temporal outer retina (p>0.5). The difference between the mean thickness of the 2 groups was 16.9µm in the nasal outer retina compared to 0.49µm in the temporal outer retina. There was no significant difference in the OS thickness or nasal OS thickness between the two groups. Conclusions: This is the first study to demonstrate thinning of the outer retina in patients with visual field loss from chiasmal compression. Longitudinal analysis and correlation with other clinical and testing parameters are needed to further evaluate the significance of these findings. References: 1. Danesh-Meyer HV, Wong A, Papchenko T, et al. Optical coherence tomography predicts visual outcome for pituitary tumors. J Clin Neurosci. 2015;22(7):1098-1104. 2. Lee GI, Park KA, Son G, Kong DS, Oh SY. Optical coherence tomography analysis of inner and outer retinal layers in eyes with chiasmal compression caused by suprasellar tumours. Acta Ophthalmol. 2020;98(3):e373-e380. 3. De Araujo RB, Oyamada MK, Zacharias LC, Cunha LP, Preti RC, Monteiro MLR. Morphological and functional inner and outer retinal layer abnormalities in eyes with permanent temporal hemianopia from chiasmal compression. Front Neurol. 2017;8:619. 4. Ogmen BE, Ugurlu N, Faki S, Polat SB, Ersoy R, Cakir B. Retinal layers in prolactinoma patients: a spectral-domain optical coherence tomography study. Int Ophthalmol. 2021;41(4):1373-1379. Keywords: Tumors, Visual fields, Retina, Diagnostic tests (ERG, VER, OCT, HRT, mfERG, etc)yEyelid & adnexal disease Financial Disclosures: Caroline Awh; Sonia Kim; Karen Matar; Lisa Lystad; Justis Ehlers: Consultant – Novartis, Roche, Regeneron, Adverum, Stealth, Allegro, Allergan, Alcon, Zeiss, and Oxurion; grant support – Novartis, Regeneron, Roche, Stealth, Allegro, Zeiss, and Allergan.; Ang Li Grant Support: None Contact Information: Caroline Awh, [e-mail] 2024 Annual Meeting Syllabus | 445