Investigating visual field measurements on perimetry and ganglion cell complex on optical coherence tomography in patients with suprasellar tumours

Vollständiger Abstract

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Background: Suprasellar tumours can cause compressive optic neuropathy with preventable visual loss. Standard automated perimetry is central to assessment but is subjective; optical coherence tomography (OCT) provides ganglion cell complex (GCC) metrics, yet structure–function relationships in chiasmal compression remain unclear. This study evaluated the relationship between GCC thickness and visual field (VF) loss (10-2 and 30-2). Methods: Prospective observational study of patients with suprasellar tumours undergoing OCT GCC imaging and Humphrey VF testing (10-2 and 30-2). Ganglion cell complex abnormality was defined as a machine-flagged red value. Visual field abnormality was defined on the pattern deviation (PD) map as a scotoma (≥ 3 adjacent points with p < 5%). Associations between GCC thickness and VF PD were assessed, and agreement between binary classifications was evaluated. Results: Seventeen eyes were included (mean age 50.7 years; 70.0% female). Visual field abnormality was frequent (10-2: 82.4%; 30-2: 94.1%), while GCC was abnormal in 58.8%. Mean PD was −6.84 dB (10-2) and −8.66 dB (30-2). Ganglion cell complex thickness correlated with PD at 10-2 (p < 0.001) and 30-2 (p = 0.001). Agreement was moderate for GCC versus VF 10-2 (κ = 0.469) and slight for GCC versus VF 30-2 (κ = 0.164). Conclusion: Visual field abnormalities were common, with 30-2 classifying more eyes as abnormal despite normal GCC. Ganglion cell complex thickness showed a graded association with VF loss on both strategies, supporting OCT GCC as an adjunct for quantifying chiasmal compression–related dysfunction; however, binary OCT classification may miss milder functional deficits. Contribution: Supports combined OCT–perimetry interpretation and strategy-aware follow-up.