title: Ganglion cell layer-inner plexiform layer thickness and vision loss in young children with optic pathway gliomas.
abstract: OBJECTIVE
  To determine if measures of macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness can discriminate between children with and without vision loss (visual acuity or field) from their optic pathway glioma (OPG) using spectral-domain optical coherence tomography (SD-OCT).
  
  
  METHODS
  Children with OPGs (sporadic or secondary to neurofibromatosis type 1) enrolled in a prospective study of SD-OCT were included if they were cooperative for vision testing and macular SD-OCT images were acquired. Manual segmentation of the macular GCL-IPL and macular retinal nerve fiber layer (RNFL) was performed using elliptical annuli with diameters of 1.5, 3.0, and 4.5 mm. Logistic regression assessed the ability of GCL-IPL and RNFL thickness measures (micrometers) to differentiate between the normal and abnormal vision groups.
  
  
  RESULTS
  Forty-seven study eyes (normal vision = 31, abnormal vision = 16) from 26 children with OPGs were included. Median age was 5.3 years (range, 2.5-12.8). Thickness of all GCL-IPL and RNFL quadrants differed between the normal and abnormal vision groups (P < 0.01). All GCL-IPL measures demonstrated excellent discrimination between groups (area under the curve [AUC] > 0.90 for all diameters). Using the lower fifth percentile threshold, the number of abnormal GCL-IPL inner macula (3.0 mm) quadrants achieved the highest AUC (0.989) and was greater than the macula RNFL AUCs (P < 0.05).
  
  
  CONCLUSIONS
  Decreased GCL-IPL thickness (<fifth percentile) can discriminate between children with and without vision loss from their OPG. Ganglion cell layer-inner plexiform layer thickness could be used as a surrogate marker of vision in children with OPGs.
authors: George Washington University School of Medicine, Washington, DC.
authors: Sherry
authors: S
authors: Gu
authors: Natalie
authors: N
authors: Glaug
authors: Avital
authors: A
authors: Cnaan
authors: Roger J
authors: RJ
authors: Packer
authors: Robert A
authors: RA
authors: Avery
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D020339:Optic Nerve Glioma / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D015354:Vision, Low / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D014792:Visual Acuity; D014794:Visual Fields
keywords: OCT; ganglion cell; neurofibromatosis type 1; optic pathway glioma; pediatric