[Assessing the damage to visual function by optical coherence tomography and the visual field test in Saddle area tumor patients].

Objectives: To analyze the differences and correlation between the ganglion cell complex (GCC), peripapillary retinal nerve fiber layer (pRNFL) and mean deviation (MD), mean sensitivity (MS) of saddle area tumor patients, and to evaluate the feasibility of using OCT to diagnose the visual pathway damage of saddle area tumor patients.

Methods: It was a case-control study. One hundred and eighty-eight normal persons and 279 saddle area tumor patients treated in Beijing Tiantan hospital, from November 2010 to June 2011, were recruited; the saddle area tumor patients were diagnosed by surgical sample pathological analysis. The recruits were divided into four groups, including the normal group, the pituitary gland tumours group, the meningiomas group and the craniopharyngiomas group. All patients received the visual field (VF) test using the Octopus 900 automated perimeter with the central 30 degree program, and the mean thickness measurements of GCC and pRNFL were made by RTVue OCT. The Spearman rank correlation coefficient was used to assess the correlation between GCC, pRNFL and MD, MS. The differences between pRNFL and GCC among the four groups were compared.

Results: The average thickness of the pRNFL (r(sOD) = 0.369 - 0.735, r(sOS) = 0.369 - 0.691) and GCC (r(sOD) = 0.357 - 0.797, r(sOS) = 0.375 - 0.681) were correlated with MD and MS (P < 0.01), and the measurements from the meningiomas was the most significant. Comparing with the normal group's thickness of pRNFL and GCC [OD: (113.60 ± 9.13) µm and (98.04 ± 6.85) µm; OS: (114.06 ± 8.99) µm and (97.70 ± 5.83) µm], the pituitary gland tumours group [OD: (101.25 ± 19.95) µm and (91.08 ± 13.19) µm; OS: (99.96 ± 20.95) µm and (89.82 ± 15.47) µm], meningiomas group [OD:(89.54 ± 19.19) µm and (80.77 ± 10.43) µm; OS: (92.79 ± 22.00) µm and (80.43 ± 10.09) µm] and craniopharyngiomas group [OD: (94.96 ± 16.59) µm and (86.46 ± 11.65) µm; OS: (94.92 ± 15.77) µm and (86.77 ± 9.56) µm] were thinner. There was statistically significant difference of pRNFL and GCC, among the three tumor groups, and the thickness of pRNFL and GCC of the meningiomas group was the thinnest (P < 0.05).

Conclusions: The average thickness of the pRNFL and GCC is correlated with vision field damage, which can be used to evaluate optic nerve damage of saddle area tumor patients quantitatively, where the meningiomas was the most significant. The thickness of the pRNFL and GCC was thinner, and the damage to visual functions was more serious. In the three tumor groups, the meningiomas group was the most serious. In the clinic, visual field test combined with OCT were helpful to find and assess the damage to visual pathway and prognosis.