Background: We present the optical coherence tomography (OCT) findings in macular ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) in a case of a female patient with craniopharyngioma and preexisting glaucoma. Case presentation: 80-year-old female patient with a history of successfully suprasellar resection of craniopharyngioma performed eight years earlier and preexisting primary open-angle glaucoma treated with latanoprost indicated a one-month history of decreased vision in the left eye. The visual field showed a vertical hemifield defect in the right eye and an inferior arcuate defect in the left eye. A cerebral magnetic resonance image confirmed a new suprasellar tumor. The patient was successfully operated on one week after diagnosis. Visual acuity in her left eye improved substantially after surgery. Results: Optical coherence tomography of macular and RNFL showed thinning in the patient’s right eye that corresponded with the vertical visual field defect. A “C” pattern that compromised the horizontal meridian differentiated from glaucoma that respects the horizontal meridian. The visual field showed a vertical hemifield defect in the right eye and an inferior arcuate defect in the left eye. Conclusions: Optical coherence tomography is a non-invasive imaging procedure. It helps identify compression of the anterior visual pathways, resulting in progressive thinning of RNFL and macular ganglion cell complex (GCC). It has a good correlation with visual fields.