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Macular ganglion cell complex thinning in children with visual field defects due to central nervous system pathology
S Noval1, M A Henríquez-Recine2, I Contreras3
1Department of Ophthalmology, Hospital Universitario La Paz, IdiPaz, Madrid, Spain.
Insights
Macular ganglion cell complex (GCC) thickness in children with central nervous system lesions correlates with visual field defects. GCC maps can help predict visual field loss in pediatric patients with neuro-ophthalmological conditions.
Area of Science:
- Ophthalmology
- Neuroscience
- Pediatrics
Background:
- Central nervous system (CNS) lesions can cause visual field defects (VFD) in children.
- Assessing VFD in pediatric patients can be challenging.
- Macular ganglion cell complex (GCC) thickness is a potential indicator of retinal nerve fiber layer damage.
Purpose of the Study:
- To investigate the relationship between GCC thickness and VFD in children with CNS lesions.
- To determine if GCC maps can predict VFD in this population.
- To evaluate the utility of GCC maps in identifying chiasmal and retrochiasmal lesions.
Main Methods:
- Retrospective analysis of GCC maps from children with VFD due to CNS lesions, other neuro-ophthalmological issues, and healthy controls.
- Two masked evaluators predicted VFD (normal, hemianopia, diffuse) based on GCC damage.
- Statistical analysis including t-tests and Kappa coefficients to compare GCC thickness and VFD predictions.
Main Results:
- Children with CNS lesions showed significantly reduced GCC thickness in affected hemiretinas compared to non-affected ones (56.04 μm vs. 74.31 μm, p < 0.001).
- Evaluators demonstrated good agreement (Kappa 0.705 and 0.658, p < 0.001) in predicting VFD from GCC maps.
- Affected hemifields had significantly worse mean deviation (MD) values (-26.00 dB) than non-affected hemifields (-5.51 dB, p < 0.001).
Conclusions:
- GCC thickness is a reliable indicator of visual pathway damage in children with CNS lesions.
- GCC maps show promise as a tool for predicting VFD and identifying specific lesion locations (chiasmal, retrochiasmal).
- GCC mapping may serve as a surrogate marker for visual impairment in non-perimetric pediatric patients.
Purpose:
To study the relationship between macular ganglion cell complex (GCC) thickness and visual field defects (VFD) caused by central nervous system (CNS) lesions in children and evaluate the possibility of predicting VFD according to GCC maps.
Methods:
The GCC maps of a group of children with VFD due to CNS lesions with respect of the vertical meridian in at least one eye (study group), as well as of children with other neuro-ophthalmological problems and healthy children were presented to two masked evaluators, who were asked to predict the patients' VFD on the basis of GCC damage: the evaluators classified VFD as normal, hemianopia (homonymous or heteronymous) or diffuse.
Results:
Seventeen patients were included in the study group, with a median age of 12 years. Fifteen had brain tumours and two epilepsy. The mean MD of the affected hemifields was -26.00 dB (SD 7.89 dB) versus -5.51 dB (SD 3.52 dB) for the nonaffected hemifields, p < 0.001. The mean GCC thickness was of 56.04 μm (SD 11.95 μm) in the affected hemiretinas versus 74.31 μm (SD 10.64 μm) for the non-affected, p < 0.001. Kappa coefficients between VFD and those estimated by the evaluators were 0.705 and 0.658 (p < 0.001) for evaluators 1 and 2.
Conclusions:
GCC thickness can reflect damage to the visual pathway and GCC maps may be useful to identify chiasmal and retrochiasmal lesions, since GCC atrophy in most of these cases respects the vertical meridian. GCC maps might be used as a surrogate marker for visual damage in patients unable to perform perimetry.
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