The diagnostic accuracy and prognostic value of OCT for the evaluation of the visual function in children with a brain tumour: A systematic review

Abstract

Purpose To systematically review the evidence on the diagnostic accuracy and prognostic value of retinal optical coherence tomography (OCT) to detect visual acuity (VA) or visual field (VF) loss in children with a brain tumour. Methods PubMed, Embase and Cochrane Library databases were searched from inception to February 2021. We included studies evaluating retinal OCT and standard visual function parameters (VA and or VF) in children with a brain tumour. Two authors independently extracted data from each included study. They also assessed the methodological quality of the studies using the QUADAS-2 or QUIPS tool. The diagnostic accuracy of OCT was evaluated with receiver operating characteristic analysis, sensitivity, specificity, positive predictive value and negative predictive value. The prognostic value of OCT was evaluated with predictive measures (odds ratio). Results We included five diagnostic studies, with a total of 186 patients, all diagnosed with optic pathway glioma. No prognostic studies were eligible for inclusion. Included studies evaluated either retinal nerve fiber layer (RNFL) thickness or ganglion cell layer—inner plexiform layer (GCL-IPL) thickness. There was considerable heterogeneity between OCT devices, OCT protocols, visual function parameters and threshold values. Sensitivity and specificity for RNFL thickness measurement ranged from 60.0% to 100.0% and 76.6% to 100%, respectively. For GCL-IPL thickness measurement, area under the curve ranged from 0.91 to 0.98 for different diameters. Conclusion The literature regarding the diagnostic accuracy and prognostic value of OCT parameters in children with a brain tumour is scarce. Due to heterogeneity and a considerable risk of bias of included studies, we cannot draw solid conclusions regarding the accuracy of retinal OCT. Future research should investigate the potential of OCT as diagnostic and prognostic tool for the evaluation of the visual function and detection of visual impairment in children with any type of brain tumour.

Diagnostic accuracy of retinal optical coherence tomography in children with a newly diagnosed brain tumour

“…Our literature review showed that previous studies only assessed the diagnostic accuracy in children diagnosed with OPG (Nuijts, Imhof, et al, 2021). These studies demonstrated higher overall sensitivity, specificity, PPVs and NPVs for average RNFL thickness (Avery et al, 2014; Avery, Cnaan, et al, 2015; Fard et al, 2013; Gu et al, 2014; Parrozzani et al, 2018) and average GCL‐IPL (Gu et al, 2014) thickness measurements as compared to our subgroup analysis.…”

“…decreased VA and VF defects) is associated with thinning of the circumpapillary retinal nerve fibre layer (RNFL) and macular ganglion cell layer – inner plexiform layer (GCL‐IPL) in children with an OPG (Avery et al, 2014; Avery, Cnaan, et al, 2015; Fard et al, 2013; Gu et al, 2014; Parrozzani et al, 2018). In a recent systematic review, we found that studies evaluating the diagnostic accuracy of circumpapillary RNFL thickness and macular GCL‐IPL thickness measurements for estimating the visual function (VA and VF) in different subtypes of brain tumours in children are lacking (Nuijts, Imhof, et al, 2021). Therefore, we aimed to prospectively investigate the diagnostic accuracy of circumpapillary RNFL thickness and macular GCL‐IPL thickness measurements to discriminate an abnormal visual function in children recently diagnosed with a brain tumour.…”

Optical Coherence Tomography Significance in Managing Early Onset of Optic Pathway Gliomas in Children Younger than 5 Years of Age—A Retrospective Study

“…Recently, Nuijts et al [ 14 ] tried to define the accuracy and prognostic value of OCT in pediatric brain tumours, but the authors found scarce literature on this topic. Nevertheless, increasing evidence reported the importance of the pRNFL thickness analysis during the follow-up period of young patients affected by OPGs.…”