Visual outcomes and predictors in optic pathway glioma: a single centre study

Area of Science:

• Ophthalmology
• Neuro-oncology
• Pediatric neurology

Background:

• Optic pathway gliomas (OPGs) can lead to progressive vision loss, even with chemotherapy.
• Newer treatments may be considered earlier based on visual prognosis.

Purpose of the Study:

• To evaluate the prognostic value of visual evoked potentials (VEP) and optical coherence tomography (OCT) in predicting visual outcomes for OPG patients.
• To identify predictors of visual acuity and visual field defects in OPG.

Main Methods:

• Retrospective analysis of 60 OPG patients treated between 2003 and 2017.
• Assessment of visual acuity using the PEDIG category and analysis of peripapillary retinal nerve fiber layer (RNFL) thickness via OCT.
• Logistic regression analysis to identify predictors of visual outcomes and homonymous hemianopias.

Main Results:

• Mean RNFL thickness on OCT predicted good final visual acuity in the better eye (p=0.038).
• Presenting visual symptoms and poorer VEP scores predicted poor final visual acuity in the worse eye (p=0.017, p=0.027).
• Poor presenting binocular VEP scores predicted homonymous hemianopias (p=0.02).

Conclusions:

• Both RNFL thickness (OCT) and VEP are valuable tools for predicting future visual acuity and vision in OPG patients.
• These neurophysiological and imaging techniques may aid in treatment planning for OPG.
• A high prevalence of homonymous hemianopia was observed in the study cohort.