ABSTRACT
Preservation of visual functions in patients with chiasmo-sellar region compression (CSRC) is possible with early diagnosis and surgical decompression. PURPOSE: To analyze the parameters of optical coherence tomography (OCT) and optical coherence tomography-angiography (OCTA) in patients with CSRC. MATERIAL AND METHODS: The study included 10 patients (20 eyes) with CSRC, 15 healthy volunteers (30 eyes). OCT, OCTA was performed on Cirrus HD-OCT 5000 AngioPlex™ (Carl Zeiss Meditec, U.S.A.) with AngioVue system. RESULTS: Patients with CSRC were revealed to have decreased thickness of ILM-RPE in the nasal sector of outer circle (p<0.001) and average mGCIPL - total and for all six sectors (p<0.001), decreased RNFL in the inferior sector (p=0.017); decreased superficial vessel density (SVD) and perfusion density in the inner and outer circle areas and in all sectors of the ETDRS grid (p<0.001) except temporal; in the peripapillary area, decreased vessel perfusion density (VPD) in the inferior sector (p=0.025), capillary flux index (CFI) in all sectors (p<0.001; p=0.025 in the inferior sector). Informative diagnostic criteria included ILM-RPE in nasal sector of the outer circle (AUC=0.896); mGCIPL in the inferonasal sector (AUC=0.914), average (AUC=0.846), superior (AUC=0.829) and superonasal (AUC=0.846) sectors; average SVD (AUC=0.805) and SVD in the inner circle area (AUC=0.810); CFI in the inferior sector (AUC=0.806) with p<0.001. CONCLUSION: In CSRC, changes can be seen in OCT and OCTA parameters recorded in the macular and peripapillary regions before the changes in the central visual field. Informative diagnostic OCT and OCTA criteria can help diagnose the pathology early, expand the indications for decompression, and preserve the visual funcitons.
Subject(s)
Optic Disk , Tomography, Optical Coherence , Angiography , Humans , Retinal Ganglion Cells , Retinal Vessels/diagnostic imagingABSTRACT
AIM: To evaluate the results of surgical treatment of patients with unilateral MRI-positive temporal forms of drug-resistant epilepsy. MATERIAL AND METHODS: A prospective analysis of 50 patients with unilateral MRI-positive temporal forms of drug-resistant epilepsy, who had undergone resective surgery in the Scientific Research Institute of Emergency Medicine of N.V. Sklifosovsky (Moscow) and in University Clinic of Moscow State University of Medicine and Dentistry between 01.01.14 and 12.12.17, has been performed. MRI-positive temporal symptomatic epilepsy was identified in 79 (55%) patients. MRI results showed unilateral temporal epileptogenic lesions in 50 (67%) patients. These patients were assigned to medial frontal lobectomy. RESULTS: 82% patients become 'seizure free' 12 and 24 months after surgical treatment. In other cases, seizures become less frequent and severe. CONCLUSION: The results confirm the efficacy and safety of surgical treatment of drug-resistant MRI-positive temporal forms of epilepsy.
