Correlation of optical coherence tomography parameters with clinical and radiological progression in patients with symptomatic optic pathway gliomas.

PURPOSE: To study the optical coherence tomography (OCT) characteristics in children with optic pathway glioma (OPG) to determine if OCT changes occur alongside clinical/radiological changes at diagnosis and during the second-year follow-up.

METHODS: Twenty-three patients (38 eyes) diagnosed with symptomatic OPG in a single institution were enrolled in this longitudinal observational cohort study. Complete ophthalmologic evaluation, including determination of visual acuity, visual fields, retinal nerve fiber layer ,and posterior pole retinal thickness scanning with spectral-domain optical coherence tomography, and neuroimaging was performed at the time of diagnosis and 6 months and 1 and 2 years after presentation. Patients who experienced visual decline or radioagraphic tumor enlargement of the OPG were classified as progressors. OCT data were compared between progressors and nonprogressors.

RESULTS: The average age at diagnosis was 5.8 years. All patients were followed up for 24 months. Five patients (21%) (eight eyes) had clinical or radiological progression of their OPG during follow-up and were classified as progressors. Mean changes in average nerve fiber layer and posterior pole retinal thickness were significantly higher for progressors compared with nonprogressors (P < 0.001). The area under the receiver operator characteristic curves comparing average nerve fiber layer and posterior pole retinal thinning between the progressors and nonprogressors were 0.94 and 0.95 respectively.

CONCLUSIONS: Optical coherence tomography of average nerve fiber layer and posterior pole retinal thickness may be helpful in monitoring OPG.