Abstract
Objective
To evaluate the functional changes after treatment of paediatric optic pathway gliomas (OPGs).
Methods
All patients with monofocal OPG seen from January 2004 to January 2011 were included. Best corrected visual acuity (BCVA, LogMAR), contrast sensitivity (Hiding-Heidi low-contrast ‘face’ test (HH) and Pelli−Robson (PR) contrast sensitivity test), and the Color Test (Ishihara plate) were obtained.
Results
Twenty-one patients (10 boys and 11 girls with a mean age of 5.5±4.4 years at diagnosis) were included in the study. Neurofibromatosis was present in four cases. Eighteen patients (85.7%) were treated with initial surgery and three patients (14.3%) with initial chemotherapy. BCVA was 0.67±0.8 LogMAR at baseline and 0.62±0.9 LogMAR at last visit (P=0.41). The Color test was not significantly changed at last visit (P=0.62). Contrast sensitivity with the HH test was 9.1±11.1% at baseline and 3.8±6.4% at last visit (P=0.03). Contrast sensitivity with PR chart was 1.33±0.9log at baseline and 1.05±0.7 log at last visit (P=0.005). A reduction in contrast sensitivity at both tests was significantly greater in patients who relapsed than in patients who did not relapse (P=0.001).
Conclusion
After the treatment of paediatric optic pathway low-grade gliomas, a reduction in contrast sensitivity during follow-up was observed and may be correlated with tumour relapses.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Binning MJ, Liu JK, Kestle JR, Brockmeyer DL, Walker ML . Optic pathway gliomas: a review. Neurosurg Focus 2007; 23: E2.
Czyzyk E, Jóźwiak S, Roszkowski M, Schwartz RA . Optic pathway gliomas in children with and without neurofibromatosis 1. J Child Neurol 2003; 18: 471–478.
Dutton JJ . Gliomas of the anterior visual pathway. Surv Ophthalmol 1994; 38: 427–452.
Lee AG, Dutton JJ . A practice pathway for the management of gliomas of the anterior visual pathway: an update and an evidence-based approach. Neuroophthalmol 1999; 22: 139–155.
Thiagalingam S, Flaherty M, Billson F, North K . Neurofibromatosis type 1 and optic pathway gliomas: follow-up of 54 patients. Ophthalmol 2004; 111: 568–577.
Blaney SM, Kun LE, Hunter J . Tumors of the optic pathway. In: Pizzo PA, Poplack DG eds. Principles and Practice of Pediatric Oncology (5th edn). Lippincott Williams and Wilkins: Philadelphia, 2006; 833–835.
Jahraus CD, Tarbell NJ . Optic pathway gliomas. Pediatr Blood Cancer 2006; 46: 586–596.
Alvord EC Jr, Lofton S . Gliomas of the optic nerve or chiasm: outcome by patients’ age, tumor site, and treatment. J Neurosurg 1988; 68: 85–98.
Grill J, Laithier V, Rodriguez D, Raquin MA, Pierre-Kahn A, Kalifa C . When do children with optic pathway tumors need treatment? An oncological perspective in 106 patients treated in a single centre. Eur J Pediatr 2000; 159: 692–696.
Perilongo G, Moras P, Carollo C, Battistella A, Clementi M, Laverda A et al. Spontaneous partial regression of lowgrade glioma in children with neurofibromatosis-1: a real possibility. J Child Neurol 1999; 14: 352–356.
Piccirilli M, Lenzi J, Delfinis C, Trasimeni G, Salvati M, Raco A . Spontaneous regression of optic pathways gliomas in three patients with neurofibromatosis type I and critical review of the literature. Childs Nerv Syst 2006; 22: 1332–1337.
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK . WHO Classification of Tumours of the Central Nervous System (4th edn). IARC: Lyon, 2007.
Schmandt SM, Packer RJ, Vezina LG, Jane J . Spontaneous regression of low-grade astrocytomas in childhood. Pediatr Neurosurg 2000; 32: 13–16.
Avery RA, Liu GT, Fisher MJ, Quinn GE, Belasco JB, Phillips PC et al. Retinal nerve fiber layer thickness in children with optic pathway gliomas. Am J Ophthalmol 2011; 151: 542–549.
Kelly JP, Leary S, Khanna P, Weiss AH . Longitudinal measures of visual function, tumor volume, and prediction of visual outcomes after treatment of optic pathway gliomas. Ophthalmol 2012; 119: 1231–1237.
Tytla M, Buncic JR . Optic nerve compression impairs low spatial frequency vision in man. Clin Vision Sci 1988; 2: 179–186.
Kupersmith MJ, Siegel IM, Carr RE . Subtle disturbances of vision with compressive lesions of the anterior visual pathway measured by contrast sensitivity. Ophthalmol 1982; 89: 68–72.
Avery RA, Fisher MJ, Liu GT . Optic pathway gliomas. J Neuroophthalmol 2011; 31: 269–278.
Stokland T, Liu JF, Ironside JW, Ellison DW, Taylor R, Robinson KJ et al. A multivariate analysis of factors determining tumor progression in childhood low-grade glioma: a population-based cohort study (CCLG CNS9702). Neuro Oncol 2010; 12: 1257–1268.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Magli, A., Forte, R., Cinalli, G. et al. Functional changes after treatment of optic pathway paediatric low-grade gliomas. Eye 27, 1288–1292 (2013). https://doi.org/10.1038/eye.2013.186
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2013.186
Keywords
This article is cited by
-
Complications and visual outcomes following surgical resection of pediatric optic pathway/hypothalamic gliomas: a systematic review and meta-analysis
Child's Nervous System (2024)
-
Visual function assessed by visually evoked potentials in optic pathway low-grade gliomas with and without neurofibromatosis type 1
Documenta Ophthalmologica (2018)
-
Optical coherence tomography as a marker of vision in children with optic pathway gliomas
Child's Nervous System (2018)
