Evaluation of inner retinal layers in eyes with temporal hemianopic visual loss from chiasmal compression using optical coherence tomography.
OBJECTIVE
We measured macular inner retinal layer thicknesses using frequency-domain optical coherence tomography (fd-OCT) and correlated these measures with visual field (VF) in eyes with temporal hemianopia from chiasmal compression and band atrophy (BA) of the optic nerve.


METHODS
Macular fd-OCT scans and VFs were obtained from 33 eyes of 33 patients with temporal hemianopia and 36 control eyes. The macular retinal nerve fiber layer (mRNFL), combined retinal ganglion cell and inner plexiform layers (RGCL+), and the inner nuclear layer (INL) were segmented. Measurements were averaged for each macula quadrant. Scans were assessed qualitatively for microcysts in the INL. The VF was estimated from the central 16 test points. The two groups were compared. Correlations between VF and OCT measurements were assessed.


RESULTS
The mRNFL, RGCL+, and total retinal (TR) macular thickness measurements were significantly smaller in BA eyes than controls. In the nasal quadrants, INL measurements were significantly greater in BA eyes than controls. The mRNFL and RGCL+ measurements had greater discrimination ability than TR measurements in the temporal quadrants. A significant correlation was found between most OCT parameters and their corresponding VF parameters. The strongest association was observed between RNFL and RGCL+ thickness, and VF loss in the corresponding area. The INL microcysts were found in seven eyes with BA, but not in controls.


CONCLUSIONS
Band atrophy leads to mRNFL and RGCL+ thinning, and INL thickening, and mRNFL and RGCL+ measurements are correlated strongly with VF loss. Segmented macular thickness measurements may be useful for quantifying neuronal loss in chiasmal compression.
Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.
Mário L R
ML
Monteiro
Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.
Kenzo
K
Hokazono
Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.
Danilo B
DB
Fernandes
Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.
Luciana V F
LV
Costa-Cunha
Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.
Rafael M
RM
Sousa
Department of Psychology, Columbia University, New York, New York, United States Department of Neurobiology and Behavior, Columbia University, New York, New York, United States.
Ali S
AS
Raza
Department of Psychology, Columbia University, New York, New York, United States.
Diane L
DL
Wang
Department of Psychology, Columbia University, New York, New York, United States Department of Ophthalmology, Columbia University, New York, New York, United States.
Donald C
DC
Hood
D000328:Adult; D003251:Constriction, Pathologic; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006423:Hemianopsia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009897:Optic Chiasm / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*; D055815:Young Adult
band atrophy; inner nuclear layer; macular thickness; optical coherence tomography; retinal ganglion cell layer thickness; retinal nerve fiber layer