Artikel
Intraoperative change of the fractional anisotropy of the optic chiasma during resection of suprasellar tumor as an early predictor of the visual outcome
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Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: The fractional anisotropy (FA) is one of the indices obtained from the DTI and indicates the neural integrity. In this study we correlated the intraoperative change in the FA of the optic chiasma after its decompression to the early and delayed visual outcome in patients with suprasellar tumors operated under intraoperative MRI control.
Methods: Thirty sequential patients with suprasellar tumors presented with chiasma compression syndrome were operated under intraoperative MRI control between March 2014 and March 2016 and included in this study. The FA of the optic chiasma was measured immediately before and immediately after tumor resection. The visual impairment score (VIS) was used to quantify the extent of ophthalmological disturbances before surgery, within 2 weeks, and 3 months after surgery. Wilcoxon Signed-Rank Test was used to compare the VIS before and after surgery and the FA before and after surgery. The correlation between the change in the FA and the early and late improvement of the VIS was tested using Spearman's rank correlation coefficient.
Results: The VIS improved significantly after surgery as assessed by Wilcoxon Signed-Rank Test. The FA values of the optic chiasma decreased significantly after decompression. Interestingly, the early and the delayed improvement of the VIS was strongly correlated to the decrease in the average FA values of the optic chiasma after its decompression. It can also predict delayed improvement in patients with early postoperative unchanged or even deteriorated visual status.
Conclusion: The intraoperative decrease of the FA of the optic chiasma is directly related the early and the delayed improvement of visual impairment. It could be used as an early predictor of the visual outcome even in patients with unchanged or even worsened early postoperative visual status.