Background: The comparison of the diagnostic value of peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell complex (mGCC) for optic nerve injury has not been reported. The aim of this study was to investigate the value of spectral domain-optical coherence tomography (SD-OCT) in the early diagnosis of optic nerve injury in patients with occupying lesion in sellar region.
Methods: A prospective case-control study was conducted for patients who were diagnosed with the occupying lesion in sellar region in the Department of Ophthalmology. The general routine examination and visual field examination were performed. A total of 22 patients (44 eyes) with no abnormalities were selected, and 22 healthy controls (44 eyes) were enrolled (age ≥18 years). SD-OCT was used to detect the average thickness of peripapillary retinal nerve fiber layer (pRNFL) and the thickness of four quadrants and the thickness of each layer of macular ganglion cell complex (mGCC). The results were compared to evaluate the damage of the optic nerve. The area under the receiver operating characteristic (ROC) curve (AUC) was evaluated by SD-OCT to detect the diagnostic efficacy of pRNFL and mGCC for sellar-occupying optic nerve damage.
Results: The average thickness of pRNFL was significantly thinner than that of healthy controls (P<0.01). The mean thickness of mGCC, macular retinal nerve fiber layer (mRNFL) and GCL+ were significantly thinner than those of healthy controls (P<0.05). The AUC values of pRNFL, mGCC, ganglion cell layer (GCL) + and mGCC were 0.757, 0.643, 0.702 and 0.688, respectively. The diagnostic value was pRNFL> GCL+ > mGCC > mRNFL.
Conclusion: The thickness of pRNFL and mGCC detected by SD-OCT has clinical value in the diagnosis of optic nerve injury in early patients with occupying lesion in sellar region. The change of pRNFL thickness is more effective than mGCC thickness in the early retrograde optic nerve changes, which has potential clinical use value for the diagnosis of retrograde optic nerve changes.