Longitudinal change of circumpapillary retinal nerve fiber layer thickness in children with optic pathway gliomas

Robert A. Avery, Avital Cnaan, Joel S. Schuman, Carmelina Trimboli-Heidler, Chieh Li Chen, Roger J. Packer, Hiroshi Ishikawa

    Research output: Contribution to journalArticle

    Abstract

    Purpose To evaluate longitudinal changes in circumpapillary retinal nerve fiber layer (RNFL) thickness, as measured by spectral-domain optical coherence tomography (SD OCT), in children with optic pathway gliomas. Design Longitudinal cohort study. Methods Global and quadrant-specific circumpapillary RNFL thickness measures were acquired using either a hand-held SD OCT during sedation or a table-top SD OCT in children old enough to cooperate. Vision loss was defined as either a 0.2 logMAR decline in visual acuity or progression of visual field. Percent change in circumpapillary RNFL thickness in eyes experiencing vision loss was compared to eyes with stable vision. Results Fifty-five eyes completed 250 study visits. Ten eyes (18%) from 7 patients experienced a new episode of vision loss during the study and 45 eyes (82%) from 39 patients demonstrated stable vision across study visits. Percent decline of RNFL thickness between the baseline visit and first event of vision loss event was greatest in the superior (-14%) and inferior (-10%) quadrants as well as global average (-13%). Using a threshold of ≥10% decline in RNFL, the positive and negative predictive value for vision loss when 2 or more anatomic sectors were affected was 100% and 94%, respectively. Conclusions Children experiencing vision loss from their optic pathway gliomas frequently demonstrate a ≥10% decline of RNFL thickness in 1 or more anatomic sectors. Global average and the inferior quadrant demonstrated the best positive and negative predictive values. Circumpapillary RNFL is a surrogate marker of vision and could be helpful in making treatment decisions for children with optic pathway gliomas.

    Original languageEnglish (US)
    Pages (from-to)944-952.e1
    JournalAmerican Journal of Ophthalmology
    Volume160
    Issue number5
    DOIs
    StatePublished - Nov 2015

    ASJC Scopus subject areas

    • Ophthalmology

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  • Cite this

    Avery, R. A., Cnaan, A., Schuman, J. S., Trimboli-Heidler, C., Chen, C. L., Packer, R. J., & Ishikawa, H. (2015). Longitudinal change of circumpapillary retinal nerve fiber layer thickness in children with optic pathway gliomas. American Journal of Ophthalmology, 160(5), 944-952.e1. https://doi.org/10.1016/j.ajo.2015.07.036