Visual outcomes after chemotherapy for optic pathway glioma in children with and without neurofibromatosis type 1: results of the International Society of Paediatric Oncology (SIOP) Low-Grade Glioma 2004 trial UK cohort

Falzon, Kevin; Drimtzias, Evangelos; Picton, Susan; Simmons, Ian

doi:10.1136/bjophthalmol-2017-311305

Cited by 56 publications

(56 citation statements)

References 23 publications

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“…Other studies described that young age, sporadic type, poor IVA, optic disk pallor, tumor volume, and tumor involvement of the chiasma/hypothalamus/post-chiasm may be associated with poor VA prognosis (17,(35)(36)(37)(38)(39). One patient with tumor recurrence suffered significant further visual impairment in the present study, which suggests that recurrence may be associated with vision deterioration.…”

Section: Discussionsupporting

confidence: 58%

“…After decompression surgery treatment, threefifths of the eyes maintained normal vision at all times, and onethird of vision-impaired eyes had VA improvement. One study reported VA improvement of ∼18.18% in sporadic OPG after chemotherapy (38), whereas ours yielded a greater improvement rate of 29.87% after decompression surgery. This may suggest that some children may benefit from better VA outcome from decompression surgery as compared to chemotherapy.…”

Section: Discussioncontrasting

confidence: 49%

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The Visual Acuity Outcome and Relevant Factors Affecting Visual Improvement in Pediatric Sporadic Chiasmatic–Hypothalamic Glioma Patients Who Received Surgery

et al. 2020

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Background: The role and effectiveness of primary surgical treatment for sporadic chiasmatic-hypothalamic glioma (CHG) are not clear. The present study was to describe sporadic CHG visual acuity (VA) outcomes after surgery and to analyze the relevant factors affecting VA improvement. Methods: Forty-five pediatric sporadic CHG patients who met the inclusion criteria were included in a retrospective study. All patients received primary intratumor partial resection. Disease characteristics, treatment strategies, complications, and VA outcome were analyzed. Univariate and multivariate analyses were performed to identify relevant factors of VA improvement. Receiver operating characteristic (ROC) analysis was performed to evaluate the predictive accuracy of measurement indexes. Results: There were 77 eyes of 45 children suffering from various levels of VA impairment before surgical treatment, and only 13 eyes had normal vision. Patients with resection extents >70, 50-70, and <50% accounted for 26.67, 24.44, and 48.89%, respectively. The percentages of VA maintained and deteriorated in normal vision eyes were 61.54 and 38.46%. The percentages of VA improved, maintained, and deteriorated in visually impaired eyes after surgery were 29.87, 45.45, and 24.68%, respectively. There was a positive correlation between the IVA level and VA improvement. There was no significant difference in VA improvement between the different resection extents. Blindness occurred in ∼4.4%. Approximately 11.1% of the children had complications that affected quality of life, which correlated with resection extent. IVA and tumor size were correlated with VA improvement. The AUC for IVA + tumor size predicting VA improvement was 0.831. The cutoff points for IVA level and tumor volume were 4.5 and 43.50 cm 3 , respectively. Conclusions: IVA and tumor size were correlated with VA improvement after primary intratumor partial resection. Children with IVA ≥ level 5 were more likely to achieve visual Liao et al. Vision Outcomes of Pediatric CHG improvement after decompression surgery, but decompression had limited effectiveness on vision improvement in patients with tumor volumes ≥ 43.50 cm 3. Performing resections < 50% was safe and did not reduce the effect of decompression to improve VA.

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Section: Discussionsupporting

confidence: 58%

Section: Discussioncontrasting

confidence: 49%

The Visual Acuity Outcome and Relevant Factors Affecting Visual Improvement in Pediatric Sporadic Chiasmatic–Hypothalamic Glioma Patients Who Received Surgery

et al. 2020

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“…However, the cutoff for treatment is not always well defined [28]. As previously stated, the visual assessment is crucial to the decision-making process regarding initiation of treatment [1,23,48,71]. Substantial VA deterioration is used as a guideline for treatment unequivocally; a documented reduction of two lines (loss of 0.2 logMAR) on an age-appropriate chart or with preferential looking VA assessment (Teller) should warrant treatment [8,11,46].…”

Section: Screening and Follow-up Recommendationsmentioning

confidence: 99%

“…As visual functions may stay stable without treatment in the majority of cases [46], unnecessary chemotherapy should be avoided. One of the clinical challenges is that tumour size does not necessarily correlate with visual outcome [23,28,38]. Therefore, the clinical evaluation of optic nerve functions is essential to management.…”

mentioning

confidence: 99%

Visual function tests including the role of optical coherence tomography in neurofibromatosis 1

et al. 2020

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Optic pathway glioma (OPG) is a common and significant complication of neurofibromatosis 1 (NF-1) that might lead to vision loss. The main reason to treat OPG is to preserve vision. Tumor location along the visual pathway largely dictates the presenting signs and symptoms. Clinical ophthalmic evaluation is focused on optic nerve functions including evaluation of pupils' reaction to light, visual acuity, color vision, and visual field, as well as optic nerve appearance. An important relatively new ancillary test is optic coherence tomography (OCT) that measures the volume of retinal nerve fiber layer around the optic nerve and the ganglion cell layer-inner plexiform layer (GCL-IPL) of the macula, both proved to be strongly associated with losing vision in OPG. Accurate evaluation of vision functions plays a critical role in the decision of treatment. In this review, we describe the ophthalmological assessment including new biomarkers in clinical use. We also outline prognostic factors and current recommendations for surveillance and indications for treatment.

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“…Therapie der Wahl ist die Chemotherapie, durch die ein teilweiser Funktionserhalt des betroffenen Auges unter Umständen möglich ist. In einer 2018 publizierten multizentrischen Studie [49] hatten immerhin 32 % der Patienten nach Abschluss der Chemotherapie einen Visus < 0,2 logMar. Bei Patienten mit sporadischem Optikusgliom verbesserte sich der Visus in 18 % der Fälle, blieb stabil in 43 % und verschlechterte sich in 39 %.…”

Section: Therapieunclassified

Benigne Neoplasien der Orbita

Sonnleithner¹,

Zorn²,

Bertelmann³

2019

Augenheilkunde up2date

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Visual outcomes after chemotherapy for optic pathway glioma in children with and without neurofibromatosis type 1: results of the International Society of Paediatric Oncology (SIOP) Low-Grade Glioma 2004 trial UK cohort

Cited by 56 publications

References 23 publications

The Visual Acuity Outcome and Relevant Factors Affecting Visual Improvement in Pediatric Sporadic Chiasmatic–Hypothalamic Glioma Patients Who Received Surgery

The Visual Acuity Outcome and Relevant Factors Affecting Visual Improvement in Pediatric Sporadic Chiasmatic–Hypothalamic Glioma Patients Who Received Surgery

Visual function tests including the role of optical coherence tomography in neurofibromatosis 1

Benigne Neoplasien der Orbita

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