NANOSNET

Wondering if anyone is using Spectralis OCT GCL to detect early signs of chiasmopathy in pituitary tumors and what microns are being used as normal findings?

I've been using spectralis for the past 9 years, although not exclusively. Here are some of the tips:

1. As with RNFL, it is better for progression rather than using absolute cut-offs as there is wide anatomic variance and other conditions may impact baseline GCL
2. I use the 1,2,3 mm ring, some general guidelines:
   a. 0.30 mm3 volume and above is normal
   b. 0.26-0.3 mm3 would be borderline
   c. 0.22-0.26 mm3 would be mild thinning
   d. 0.18-0.22 mm3 would be moderate thinning
   e. <0.18 mm3 would be severe thinning - it tends to bottom out around 0.12-0.14 mm3
3. for chiasmal disease specifically on the Spectralis, you can compare the macula GCL nasal quadrant to temporal quadrant (macula nasal-temporal ratio = mNTR): When distinguishing chiasmal compression from POAG, an optimal diagnostic mNTR threshold of <0.99 was identified (nasal thinner than temporal), which was associated a specificity of 100% and a sensitivity of 84%. When comparing with healthy controls, a mean mNTR threshold of <0.96 was associated with a specificity of 100% and a sensitivity of 77% in identifying chiasmal compression and an NTR threshold of >1.06 was associated with a specificity of 88% and a sensitivity of 60% in identifying glaucoma - (Kleerekooper et al. Differentiating glaucoma from chiasmal compression using optical coherence tomography: the macular naso-temporal ratio. Br J Ophthalmol. 2024 May).

Best,

Drew

Wondering if anyone is using Spectralis OCT GCL to detect early signs of chiasmopathy in pituitary tumors and what microns are being used as normal findings?

Andrew,

Thank you very much. This is very helpful.

Nancy

I've been using spectralis for the past 9 years, although not exclusively. Here are some of the tips:

1. As with RNFL, it is better for progression rather than using absolute cut-offs as there is wide anatomic variance and other conditions may impact baseline GCL
2. I use the 1,2,3 mm ring, some general guidelines:
   a. 0.30 mm3 volume and above is normal
   b. 0.26-0.3 mm3 would be borderline
   c. 0.22-0.26 mm3 would be mild thinning
   d. 0.18-0.22 mm3 would be moderate thinning
   e. <0.18 mm3 would be severe thinning - it tends to bottom out around 0.12-0.14 mm3
3. for chiasmal disease specifically on the Spectralis, you can compare the macula GCL nasal quadrant to temporal quadrant (macula nasal-temporal ratio = mNTR): When distinguishing chiasmal compression from POAG, an optimal diagnostic mNTR threshold of <0.99 was identified (nasal thinner than temporal), which was associated a specificity of 100% and a sensitivity of 84%. When comparing with healthy controls, a mean mNTR threshold of <0.96 was associated with a specificity of 100% and a sensitivity of 77% in identifying chiasmal compression and an NTR threshold of >1.06 was associated with a specificity of 88% and a sensitivity of 60% in identifying glaucoma - (Kleerekooper et al. Differentiating glaucoma from chiasmal compression using optical coherence tomography: the macular naso-temporal ratio. Br J Ophthalmol. 2024 May).

Best,

Drew

Wondering if anyone is using Spectralis OCT GCL to detect early signs of chiasmopathy in pituitary tumors and what microns are being used as normal findings?

I've been using spectralis for the past 9 years, although not exclusively. Here are some of the tips:

1. As with RNFL, it is better for progression rather than using absolute cut-offs as there is wide anatomic variance and other conditions may impact baseline GCL
2. I use the 1,2,3 mm ring, some general guidelines:
   a. 0.30 mm3 volume and above is normal
   b. 0.26-0.3 mm3 would be borderline
   c. 0.22-0.26 mm3 would be mild thinning
   d. 0.18-0.22 mm3 would be moderate thinning
   e. <0.18 mm3 would be severe thinning - it tends to bottom out around 0.12-0.14 mm3
3. for chiasmal disease specifically on the Spectralis, you can compare the macula GCL nasal quadrant to temporal quadrant (macula nasal-temporal ratio = mNTR): When distinguishing chiasmal compression from POAG, an optimal diagnostic mNTR threshold of <0.99 was identified (nasal thinner than temporal), which was associated a specificity of 100% and a sensitivity of 84%. When comparing with healthy controls, a mean mNTR threshold of <0.96 was associated with a specificity of 100% and a sensitivity of 77% in identifying chiasmal compression and an NTR threshold of >1.06 was associated with a specificity of 88% and a sensitivity of 60% in identifying glaucoma - (Kleerekooper et al. Differentiating glaucoma from chiasmal compression using optical coherence tomography: the macular naso-temporal ratio. Br J Ophthalmol. 2024 May).

Best,

Drew

Wondering if anyone is using Spectralis OCT GCL to detect early signs of chiasmopathy in pituitary tumors and what microns are being used as normal findings?