Objective To investigate the characteristic changes in the macular ganglion cell complex (mGCC) caused by damage to the optic chiasm from lesions on the sella turcica and its diagnostic value. Methods Eleven patients with lesions on the sella turcica (diagnosed by CT/MRI/ surgery/pathology) were included in a retrospective serial case study. The thickness map of the mGCC and peripheral retinal nerve fiber layer (RNFL) around the disc were obtained by Topcon 3D-OCT2000. The changes in the mGCC and the RNFL around the disc were investigated and compared with changes in the visual field (Octopus 101 Automated Perimetry). Results Two of the 11 patients had a normal GCC and perimetry because of the small size of the lesions (too small to cause damage to the optic chiasm); nine of the 11 patients had hemianopia. In the nine patients, seven had bitemporal hemianopia with lesions at the origin of the right optic tract and two had homonymous hemianopia with the lesion at the terminal section of the left optic tract. Atrophy of the ganglion cell complex (GCC) in the nine cases was located in the nasal portion, which was consistent with the visual field defect in the temporal section. Conclusion Damage to the optic chiasm can cause atrophy of the mGCC in the bilateral nasal portion, which may have the same anatomical diagnostic value as the visual field.