Quantitative Analysis Of Peripapillary Region Perfusion In Patients With Chiasmal Compression Caused By Sellar Region Mass

Purpose:The sellar region constitutes a complex structure adjacent to the optic chiasm.Anterior visual pathway compression caused by sellar region masses is a common neuroophthalmological disorder.The main symptom of which is the decrease of the visual acuity and visual field defects in specific areas.The radial peripapillary capillary(RPC)vessel density and the peripapillary nerve fiber layer(RNFL)thickness were compared between patients with chiasmal compression caused by sellar region mass and the healthy controls using optical coherence tomography angiography(OCTA).To analyze the correlation between the symptom duration,the tumor diameter and the OCTA measurements in patients,and the correlation between the RPC vessel density and RNFL thickness.To analyze whether visual field defects is related to the OCTA measurements.Methods: This is an observational,cross-sectional study of 31 patients(31 eyes)with chiasmal compression caused by sellar region mass and 34 healthy controls(34 eyes).Best-corrected visual acuity(BCVA),which was converted to the log MAR,slit-lamp biomicroscopy,intraocular pressure(IOP),funduscopy,Automated perimetry and OCTA was performed.The RPC vessel density and RNFL thickness were compared between the two groups,and the correlation between the RPC vessel density and RNFL thickness were analyzed in patients.Furthermore,we divided the patients into two subgroups according to whether there was an absolute defect in the central visual field and evaluated their RPC vessel density and RNFL thickness,respectively.The correlation between the symptom duration,the tumor diameter and the OCTA measurements in patients were also analyzed.Results: Compared to the healthy control group,there was a statistically significant decrease in RPC vessel density and RNFL thickness in patients with chiasmal compression caused by sellar region mass(p < 0.05),especially in patients with substantial absolute defects in the central visual field.The patients’ BCVA was observed to have a statistically significant decrease after adjusting the age(p<0.05).There was a significant positive correlation between the RPC vessel density and RNFL thickness in patients with chiasmal compression(p<0.001).However,neither the symptom duration nor the diameter was found to be significantly correlated with the RPC vessel density and RNFL thickness.Conclusion: RPC vessel density and RNFL thickness are significantly decreased in patients with chiasmal compression revealed by OCTA,especially in patients with more severe visual field defects.A significant correlation between RPC vessel density and RNFL thickness was demonstrated,which provides a clue for the study of pathophysiological alterations of compressive optic neuropathy.More importantly,OCTA may be a useful tool for evaluating and monitoring disease progression in sellar region mass.