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Muñoz-Gallego A, Torres-Peña JL, Rodríguez-Salgado M, Ortueta-Olartecoechea A, López-López C, De La Cruz J, Tejada-Palacios P. Values of peripapillary retinal nerve fibre layer thickness are different in children and adults. Clin Exp Optom 2024:1-9. [PMID: 39025791 DOI: 10.1080/08164622.2024.2376199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
CLINICAL RELEVANCE The detection of abnormal values of peripapillary nerve fibre layer (pRNFL) thickness measured with optical coherence tomography (OCT) is important for detecting optic nerve disease in children. BACKGROUND To evaluate the level of agreement between the adult reference database supplied with an OCT device and the present paediatric study database for the measurement of pRNFL thickness in children. This study also aimed to provide reference values for pRNFL thickness according to the spherical equivalent in the paediatric population. METHODS This was a cross-sectional study. One hundred and twenty-six healthy children were included, who had undergone a full ophthalmological examination including cycloplegic refraction and examination of pRNFL thickness using the Topcon 3D OCT 2000 device (Topcon Corporation, Tokyo, Japan). Values equal to or below the fifth percentile (≤p5) and above the 95th percentile (>p95) were considered abnormal. Observed agreement and specific agreement were investigated between OCT measurements classified with paediatric and adult reference values for normality. RESULTS Values ≤ p5 in the adult database were recorded for 2 of the 30 values (6.6%) of the pRNFL values by quadrants ≤p5 in the paediatric database and 17 of the 88 (19.3%) values by sectors ≤p5. For values >p95 in the adult database, 88% by quadrants and 72% by sectors would have been classified as being within the normal range using the paediatric database. CONCLUSION The use of adult reference values currently available in OCT devices can lead to classification errors concerning the normal range of pRNFL thickness in a large proportion of paediatric patients. The use of normative paediatric databases, such as the one discussed in this study, should be taken into consideration.
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Affiliation(s)
| | | | | | | | | | - Javier De La Cruz
- Research Institute (imas12), Madrid University Hospital, Madrid, Spain
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Arnljots U, Nilsson M, Bolzani R, Benassi M, Sandvik U, Munoz DM, Blomgren K, Hellgren K. Optical coherence tomography of the macular ganglion cell layer in children with neurofibromatosis type 1 is a useful tool in the assessment for optic pathway gliomas. PLoS One 2024; 19:e0305548. [PMID: 38990917 PMCID: PMC11239031 DOI: 10.1371/journal.pone.0305548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/31/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Optic pathway glioma (OPG) is a feared complication to neurofibromatosis type 1 (NF1) since it can cause visual impairment in young children. The main goal of screening is to detect symptomatic OPGs that require treatment. Optical coherence tomography (OCT) has been suggested as a tool for detection of neuro-retinal damage. AIMS To investigate whether the ganglion cell layer assessed by OCT is a reliable measure to identify and detect relapses of symptomatic OPGs in children with NF1. METHODS Children (3-6 years) with NF1, with and without known OPG and children with sporadic OPG (S-OPG) resident in the Stockholm area, were invited and followed in a prospective study during a three-year period. Brain magnetic resonance tomography (MRI) had been performed in children with symptoms of OPG. Outcome measures were VA in logMAR, visual field index (VFI), average thicknesses of the ganglion cell-inner plexiform layer (GC-IPL), and peripapillary retinal nerve fiber layer (pRNFL). RESULTS There were 25 children with MRI-verified OPG and 52 with NF1 without symptomatic OPG. Eyes from NF1 patients without symptoms of OPG showed significantly better results in all four analyzed parameters compared to eyes with NF1-associated OPG. Mean GC-IPL measurements seemed stable and reliable, significantly correlated to pRNFL (correlation coefficient (r) = 0.662, confidence interval (CI) = .507 to .773 p<0.001), VA (r = -0.661, CI = -7.45 to -.551, p<0.001) and VFI (r = 0.644, CI = .452 to .774, p<0.001). GC-IPL measurements were easy to obtain and acquired at considerably younger age than pRNFL (5.6±1.5 vs 6.8±1.3; p<0.001). CONCLUSIONS The mean GC-IPL thickness could distinguish well between eyes with OPG and eyes without symptomatic OPG in children with NF1. As thinning of GC-IPL assessed with OCT could indicate underlying OPG, it should be included in the screening protocol of children with questionable VA measurements and in particular in children with NF1.
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Affiliation(s)
- Urszula Arnljots
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- St Erik Eye Hospital, Stockholm, Sweden
| | - Maria Nilsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Roberto Bolzani
- Department of Psychology, University of Bologna, Bologna, Italy
| | | | - Ulrika Sandvik
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurosurgery, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Daniel Martin Munoz
- Department of Neuroradiology and Pediatric Radiology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Klas Blomgren
- Pediatric Oncology, Astrid Lindgren Children’s Hospital Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Hellgren
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
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3
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Zeng Y, Gao S, Li Y, Marangoni D, De Silva T, Wong WT, Chew EY, Sun X, Li T, Sieving PA, Qian H. OCT Intensity of the Region between Outer Retina Band 2 and Band 3 as a Biomarker for Retinal Degeneration and Therapy. Bioengineering (Basel) 2024; 11:449. [PMID: 38790316 PMCID: PMC11118669 DOI: 10.3390/bioengineering11050449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Optical coherence tomography (OCT) is widely used to probe retinal structure and function. This study investigated the outer retina band (ORB) pattern and reflective intensity for the region between bands 2 and 3 (Dip) in three mouse models of inherited retinal degeneration (Rs1KO, TTLL5KO, RPE65KO) and in human AMD patients from the A2A database. OCT images were manually graded, and reflectivity signals were used to calculate the Dip ratio. Qualitative analyses demonstrated the progressive merging band 2 and band 3 in all three mouse models, leading to a reduction in the Dip ratio compared to wildtype (WT) controls. Gene replacement therapy in Rs1KO mice reverted the ORB pattern to one resembling WT and increased the Dip ratio. The degree of anatomical rescue in these mice was highly correlated with level of transgenic RS1 expression and with the restoration of ERG b-wave amplitudes. While the inner retinal cavity was significantly enlarged in dark-adapted Rs1KO mice, the Dip ratio was not altered. A reduction of the Dip ratio was also detected in AMD patients compared with healthy controls and was also positively correlated with AMD severity on the AMD score. We propose that the ORB and Dip ratio can be used as non-invasive early biomarkers for retina health, which can be used to probe therapeutic gene expression and to evaluate the effectiveness of therapy.
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Affiliation(s)
- Yong Zeng
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA; (Y.Z.); (S.G.); (Y.L.)
| | - Shasha Gao
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA; (Y.Z.); (S.G.); (Y.L.)
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yichao Li
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA; (Y.Z.); (S.G.); (Y.L.)
| | - Dario Marangoni
- Section for Translational Research in Retinal and Macular Degeneration, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Tharindu De Silva
- Unit on Clinical Investigation of Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Wai T. Wong
- Section on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Emily Y. Chew
- Clinical Trials Branch, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Xun Sun
- Neurobiology Neurodegeneration & Repair Laboratory (N-NRL), National Eye Institute, Bethesda, MD 20892, USA (T.L.)
| | - Tiansen Li
- Neurobiology Neurodegeneration & Repair Laboratory (N-NRL), National Eye Institute, Bethesda, MD 20892, USA (T.L.)
| | | | - Haohua Qian
- Visual Function Core, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA; (Y.Z.); (S.G.); (Y.L.)
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4
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Nuijts MA, Stegeman I, Porro GL, Bennebroek CAM, van Seeters T, Proudlock FA, Schouten-van Meeteren AYN, Imhof SM. Diagnostic accuracy of retinal optical coherence tomography in children with a newly diagnosed brain tumour. Acta Ophthalmol 2023; 101:658-669. [PMID: 36924320 DOI: 10.1111/aos.15650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/15/2023] [Accepted: 02/09/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE To estimate the diagnostic accuracy of circumpapillary retinal nerve fibre layer (RNFL) thickness and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness measurements to discriminate an abnormal visual function (i.e. abnormal age-based visual acuity and/or visual field defect) in children with a newly diagnosed brain tumour. METHODS This cross-sectional analysis of a prospective longitudinal nationwide cohort study was conducted at four hospitals in the Netherlands, including the national referral centre for paediatric oncology. Patients aged 0-18 years with a newly diagnosed brain tumour and reliable visual acuity and/or visual field examination and optical coherence tomography were included. Diagnostic accuracy was evaluated with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). RESULTS Of 115 patients included in the study (67 [58.3%] male; median age 10.6 years [range, 0.2-17.8 years]), reliable RNFL thickness and GCL-IPL thickness measurements were available in 92 patients (80.0%) and 84 patients (73.0%), respectively. The sensitivity for detecting an abnormal visual function was 74.5% for average RNFL thickness and 41.7% for average GCL-IPL thickness at a specificity of 44.5% and 82.9%, respectively. The PPV and NPV were 33.0% and 82.6% for the average RNFL thickness and 57.1% and 82.2% for the average GCL-IPL thickness. CONCLUSION An abnormal visual function was discriminated correctly by using the average RNFL thickness in seven out of ten patients and by using the average GCL-IPL thickness in four out of ten patients. The relatively high NPVs signified that patients with normal average RNFL thickness and average GCL-IPL thickness measurements had a relative high certainty of a normal visual function.
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Affiliation(s)
- Myrthe A Nuijts
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Otorhinolaryngology and Head & Neck Surgery University, University Medical Centre Utrecht, Utrecht, The Netherlands
- Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Giorgio L Porro
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Carlien A M Bennebroek
- Department of Ophthalmology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Tom van Seeters
- Department of Radiology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | | | | | - Saskia M Imhof
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Nemeș-Drăgan IA, Drăgan AM, Hapca MC, Oaida M. Retinal Nerve Fiber Layer Imaging with Two Different Spectral Domain Optical Coherence Tomographs: Normative Data for Romanian Children. Diagnostics (Basel) 2023; 13:1377. [PMID: 37189478 PMCID: PMC10137465 DOI: 10.3390/diagnostics13081377] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/26/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
The purpose of this study is to analyze and compare pediatric normative data for the retinal nerve fiber layer of Romanian children using two different spectral domain optical coherence tomographs. Due to different scanning speeds and axial and transverse resolution, the results of the measurements of scans cannot be transposed. A total of 140 healthy children aged 4 to 18 were enrolled in the study. Overall, 140 eyes were scanned with a Spectralis SD-OCT (Heidelberg Technology), and the other 140 eyes were imaged with a Copernicus REVO SOCT (Optopol Technology (Zawiercie, Poland)). The mean global RNFL thickness and average RNFL thickness for the four quadrants were measured and compared. The average peripapillary RNFL thickness measured with the Spectralis was 104.03 ± 11.42 (range 81 to 126 µm), while the one measured with the Revo 80 was 127.05 ± 15.6 (range 111.43-158.28). The RNFL thickness measurements taken with the Spectralis in the superior, inferior, nasal, and temporal quadrants were 132 ±19.1, 133.5 ± 21.77, 74 ± 16.48, and 73 ± 11.95 µm, respectively, while those taken with the Revo 80 were 144.44 ± 9.25, 144.86 ±23.12, 96.49 ± 19.41, and 77 ± 11.4 µm, respectively. Multivariate analysis showed that the average RNFL thickness was not influenced by gender or eye laterality and was negatively correlated with age when we used the Spectralis device. This study provides normative data for SD-OCT peripapillary RNFL in healthy Romanian children for two different tomographs. These data help the clinician evaluate and interpret the results of optical coherence tomography for a child, taking into consideration all the technical and individual parameters.
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Affiliation(s)
- Iulia-Andrada Nemeș-Drăgan
- Department of Ophthalmology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-5 Clinicilor Str., 400006 Cluj-Napoca, Romania
- Ophthalmology Clinic, Emergency County Hospital, 3-5 Clinicilor Str., 400006 Cluj-Napoca, Romania
| | - Ana-Maria Drăgan
- Department of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Mădălina Claudia Hapca
- Doctoral School of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8, V.Babes Str., 400012 Cluj-Napoca, Romania
| | - Mara Oaida
- General Medicine Faculty, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8, V.Babes Str., 400012 Cluj-Napoca, Romania
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Pavone R, Fonte C, Sardi I, Caputo R, Marziali E, Mazzeo F, Secci J, Bergamini A, De Masi S, Leo MC, Censullo ML, Bacci GM. Optical Coherence Tomography Significance in Managing Early Onset of Optic Pathway Gliomas in Children Younger than 5 Years of Age—A Retrospective Study. CHILDREN 2022; 9:children9091307. [PMID: 36138616 PMCID: PMC9497564 DOI: 10.3390/children9091307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/17/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022]
Abstract
We aimed to investigate the significance of optical coherence tomography (SD-OCT) in managing pediatric optic pathway gliomas (OPGs) in children younger than 5 years of age. A retrospective monocentric study was conducted. SD-OCT scans were obtained using the handheld iVue system to assess peripapillary retinal nerve fibre layer (pRNFL) thickness at three time points: baseline (OCT1), end of treatment (OCT2), and at last follow-up (OCT3). We compared the median value of pRNFL (and interquartile range—IQR) at different follow-up times and in different sub-groups (stable disease—SD, partial response—PR, and progression disease—PD). Thirteen children younger than 5 years of age were included. The Median follow-up time was 3.9 years (IQR 1.2). Six patients showed a pRNFL change of more than 10% during follow-up. Seven patients showed PD during follow-up. Median pRNFL at baseline was 81.5 µm (IQR 31.5); median pRNFL at the end of treatment was 73 µm (IQR 33); median pRNFL at last follow-up was 72 µm (IQR 38.5). The mean pRNFL at baseline was significantly lower than the mean normative values. Only subjects with PD showed pRNFL change close to statistical significance. This study confirms the role of SD-OCT in managing OPGs for therapeutic decisions and strategy planning of visual rehabilitation.
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Affiliation(s)
- Rossana Pavone
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children’s Hospital, 50134 Florence, Italy
| | - Carla Fonte
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children’s Hospital, 50134 Florence, Italy
| | - Iacopo Sardi
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children’s Hospital, 50134 Florence, Italy
| | - Roberto Caputo
- Pediatric Ophthalmology Unit, Meyer Children’s Hospital, Viale Pieraccini 24, 50134 Florence, Italy
| | - Elisa Marziali
- Pediatric Ophthalmology Unit, Meyer Children’s Hospital, Viale Pieraccini 24, 50134 Florence, Italy
| | - Fabio Mazzeo
- Pediatric Ophthalmology Unit, Meyer Children’s Hospital, Viale Pieraccini 24, 50134 Florence, Italy
| | - Jacopo Secci
- Pediatric Ophthalmology Unit, Meyer Children’s Hospital, Viale Pieraccini 24, 50134 Florence, Italy
| | - Alessia Bergamini
- Pediatric Ophthalmology Unit, Meyer Children’s Hospital, Viale Pieraccini 24, 50134 Florence, Italy
| | | | - Maria Carmela Leo
- Clinical Research and Study Design Office, Meyer Children’s Hospital, 50134 Florence, Italy
| | - Maria Luigia Censullo
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children’s Hospital, 50134 Florence, Italy
| | - Giacomo Maria Bacci
- Pediatric Ophthalmology Unit, Meyer Children’s Hospital, Viale Pieraccini 24, 50134 Florence, Italy
- Correspondence: ; Tel.: +39-(0)555662526; Fax: +39-(0)555662400
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7
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Taha Najim R, Mybeck L, Andersson S, Andersson Grönlund M. Thinner peripapillary retinal nerve fibre layer and macular retinal thickness in adolescents with surgically treated hydrocephalus in infancy. Acta Ophthalmol 2022; 100:673-681. [PMID: 35507694 DOI: 10.1111/aos.15162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/21/2022] [Accepted: 04/18/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To map the morphology of the retina and optic disc in adolescents with surgically treated hydrocephalus (HC) in infancy and to compare the results with healthy controls. METHODS The study comprised 26 adolescents (16 male, mean age 15 years) with HC and 31 sex- and aged-matched controls. The following optical coherence tomography (OCT) parameters were obtained: macular retinal thickness (MRT) and volume (MRV), thickness of the macular and peripapillary retinal nerve fibre layer (ppRNFL), and area of the optic disc, cup and rim. RESULTS The MRT was thinner amongst those with HC compared with controls (right eye (RE) 262.2 ± 15.3 and 275.8 ± 15.1 μm; p = 0.0051), and the MRV was smaller (RE 7.37 ± 0.36 and 7.83 ± 0.35 mm3 ; p = 0.0002). The HC group showed a thinner ppRNFL (RE 88.3 ± 14.9 and 103.5 ± 8.1 μm; p = 0.0002) but a thicker central macular RNFL (RE 11.6 ± 10.4 and 2.07 ± 3.00 μm; p = <0.0001) and foveal minimum (RE 211.1 ± 32.0 and 186.3 ± 15.9 μm; p = 0.0013). Optic disc variables showed no difference between groups. Correlations were found in the HC group between best corrected visual acuity (expressed in logMAR) and ppRNFL (RE r = -0.56, p = 0.018), and disc area (RE r = -0.52, p = 0.033). CONCLUSION Thinner ppRNFL and MRT and smaller MRV were found in adolescents with surgically treated HC in infancy compared with controls. In contrast, the central macular RNFL and foveal minimum were thicker. Further studies are required to evaluate the diagnostic value of OCT to indicate increased intracranial pressure timely and follow-up in individuals with surgically treated HC.
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Affiliation(s)
- Rezhna Taha Najim
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Ophthalmology Region Västra Götaland, Sahlgrenska University Hospital Mölndal Sweden
| | - Lovisa Mybeck
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - Susann Andersson
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Ophthalmology Region Västra Götaland, Sahlgrenska University Hospital Mölndal Sweden
| | - Marita Andersson Grönlund
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Deparment of Ophthalmology Faculty of Medicine and Health, Örebro University Örebro Sweden
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8
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Zhang XJ, Lau YH, Wang YM, Chan HN, Chan PP, Kam KW, Ip P, Zhang W, Young AL, Tham CC, Pang CP, Chen LJ, Yam JC. Thicker Retinal Nerve Fiber Layer with Age among Schoolchildren: The Hong Kong Children Eye Study. Diagnostics (Basel) 2022; 12:diagnostics12020500. [PMID: 35204590 PMCID: PMC8870939 DOI: 10.3390/diagnostics12020500] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/18/2022] Open
Abstract
This study aims to investigate the effect of age on the peripapillary retinal nerve fiber layer (p-RNFL) thickness among schoolchildren. A total of 4034 children aged 6–8 years old received comprehensive ophthalmological examinations. p-RNFL thickness was measured from a circular scan (⌀ = 3.4 mm) captured using spectral-domain optical coherence tomography (SD-OCT). Associations between p-RNFL thickness with ocular and systemic factors were determined by multivariate linear regression after adjusting potential confounders using generalized estimating equations (GEE). The mean global p-RNFL thickness was 106.60 ± 9.41 μm (range: 72 to 171 μm) in the right eyes, 105.99 ± 9.30 μm (range: 76 to 163 μm) in the left eyes, and 106.29 ± 9.36 μm (range: 72 to 171 μm) across both eyes. Age was positively correlated with p-RNFL after adjusting for axial length (AL) and confounding factors (β = 0.509; p = 0.001). Upon multivariable analysis, AL was positively associated with temporal p-RNFL thickness (β = 3.186, p < 0.001) but negatively with non-temporal p-RNFL thickness (β = (10.003, −2.294), p < 0.001). Sectoral p-RNFL was the thickest in the inferior temporal region (155.12 ± 19.42 μm, range 68 to 271 μm), followed by the superior temporal region (154.67 ± 19.99 μm, range 32 to 177 μm). To conclude, p-RNFL increased significantly with older age among children 6 to 8 years old in a converse trend compared to adults. Our results provide a reference for interpreting OCT information in children and suggest that stable p-RNFL thickness may not indicate a stable disease status in pediatric patients due to the age effects.
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Affiliation(s)
- Xiu-Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
- Division of Pediatric Ophthalmology and Strabismus, Tianjin Eye Hospital, Tianjin 300020, China;
| | - Yi-Han Lau
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
| | - Yu-Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
| | - Hei-Nga Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
| | - Poemen P. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China
| | - Ka-Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China;
| | - Wei Zhang
- Division of Pediatric Ophthalmology and Strabismus, Tianjin Eye Hospital, Tianjin 300020, China;
| | - Alvin L. Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Clement C. Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi-Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li-Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; (X.-J.Z.); (Y.-H.L.); (Y.-M.W.); (H.-N.C.); (P.P.C.); (K.-W.K.); (A.L.Y.); (C.C.T.); (C.-P.P.); (L.-J.C.)
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Children’s Hospital, Hong Kong SAR, China
- Correspondence: ; Tel.: +852-3943-5892; Fax: +852-2715-9490
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Nuijts MA, Imhof SM, Veldhuis N, Dekkers CC, Schouten – van Meeteren AYN, Stegeman I. The diagnostic accuracy and prognostic value of OCT for the evaluation of the visual function in children with a brain tumour: A systematic review. PLoS One 2021; 16:e0261631. [PMID: 34941930 PMCID: PMC8699950 DOI: 10.1371/journal.pone.0261631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022] Open
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.
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Affiliation(s)
- Myrthe A. Nuijts
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
- * E-mail:
| | - Saskia M. Imhof
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Nienke Veldhuis
- Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Coco C. Dekkers
- Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | | | - Inge Stegeman
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Otorhinolaryngology and Head & Neck Surgery University, University Medical Centre Utrecht, Utrecht, The Netherlands
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Epidemiology and Data Science, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Waldman AT, Benson L, Sollee JR, Lavery AM, Liu GW, Green AJ, Waubant E, Heidary G, Conger D, Graves J, Greenberg B. Interocular Difference in Retinal Nerve Fiber Layer Thickness Predicts Optic Neuritis in Pediatric-Onset Multiple Sclerosis. J Neuroophthalmol 2021; 41:469-475. [PMID: 33105412 PMCID: PMC8846428 DOI: 10.1097/wno.0000000000001070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) is capable of quantifying retinal damage. Defining the extent of anterior visual pathway injury is important in multiple sclerosis (MS) as a way to document evidence of prior disease, including subclinical injury, and setting a baseline for patients early in the course of disease. Retinal nerve fiber layer (RNFL) thickness is typically classified as low if values fall outside of a predefined range for a healthy population. In adults, an interocular difference (IOD) in RNFL thickness greater than 5 μm identified a history of unilateral optic neuritis (ON). Through our PERCEPTION (PEdiatric Research Collaboration ExPloring Tests in Ocular Neuroimmunology) study, we explored whether RNFL IOD informs on remote ON in a multicenter pediatric-onset MS (POMS) cohort. METHODS POMS (defined using consensus criteria and first attack <18 years) patients were recruited from 4 academic centers. A clinical history of ON (>6 months prior to an OCT scan) was confirmed by medical record review. RNFL thickness was measured on Spectralis machines (Heidelberg, Germany). Using a cohort of healthy controls from our centers tested on the same machines, RNFL thickness <86 μm (<2 SDs below the mean) was defined as abnormal. Based on previously published findings in adults, an RNFL IOD >5 μm was defined as abnormal. The proportions of POMS participants with RNFL thinning (<86 μm) and abnormal IOD (>5 μm) were calculated. Logistic regression was used to determine whether IOD was associated with remote ON. RESULTS A total of 157 participants with POMS (mean age 15.2 years, SD 3.2; 67 [43%] with remote ON) were enrolled. RNFL thinning occurred in 45 of 90 (50%) ON eyes and 24 of 224 (11%) non-ON eyes. An IOD >5 μm was associated with a history of remote ON (P < 0.001). An IOD >5 μm occurred in 62 participants, 40 (65%) with remote ON. Among 33 participants with remote ON but normal RNFL values (≥86 μm in both eyes), 14 (42%) were confirmed to have ON by IOD criteria (>5 μm). CONCLUSIONS In POMS, the diagnostic yield of OCT in confirming remote ON is enhanced by considering RNFL IOD, especially for those patients with RNFL thickness for each eye in the normal range. An IOD >5 μm in patients with previous visual symptoms suggests a history of remote ON.
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Affiliation(s)
- Amy T. Waldman
- Division of Neurology, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Leslie Benson
- Departments of Neurology Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - John R. Sollee
- Division of Neurology, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Amy M. Lavery
- Division of Neurology, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Geraldine W. Liu
- Division of Neurology, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Ari J. Green
- Division of Neuroimmunology and Glial Biology, Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Emmanuelle Waubant
- Division of Neuroimmunology and Glial Biology, Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Gena Heidary
- Ophthalmology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Darrel Conger
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jennifer Graves
- Department of Neurology, University of California San Diego, San Diego, CA, USA
| | - Benjamin Greenberg
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
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11
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Arnljots U, Nilsson M, Hed Myrberg I, Åden U, Hellgren K. Profile of macular ganglion cell-inner plexiform layer thickness in healthy 6.5 year- old Swedish children. BMC Ophthalmol 2020; 20:329. [PMID: 32787847 PMCID: PMC7425168 DOI: 10.1186/s12886-020-01601-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/06/2020] [Indexed: 11/12/2022] Open
Abstract
Background The purpose was to study the macular ganglion cell- inner plexiform layer (GC-IPL) thickness in healthy 6.5 year- old Swedish children using Optical Coherence Tomography (OCT) and to study topography symmetry within eyes and between eye pairs. Methods A total of 181 eyes of 92 healthy children (39 girls, 53 boys) aged 6.5 and serving as a term-born control group in the Extremely Preterm Infants in Sweden Study (EXPRESS), were examined with Cirrus HD-OCT. Main outcome measures were average and minimum values of GC-IPL thickness of the device’s predefined macular sectors. Single sectors, combined sectors defined as superior and inferior hemispheres and temporal and nasal sectors were evaluated. Intra-individual GC-IPL thickness between eye pairs was analyzed. Visual acuity, refraction and general cognition were assessed and correlated to GC-IPL outcome. Results Eighty-five children completed the OCT examination and 155 out of 181 scans (86%) were analyzed. The mean average GC-IPL thickness was 85.9 μm (± 5.3; 5th and 95th percentiles were 76.0 and 94.6 μm). The mean minimum GC-IPL thickness was 83.6 μm (± 4.9; 5th and 95th percentiles were 75.4 and 92.3 μm). The difference in thickness between nasal and temporal sectors and between superior and inferior hemisphere sectors were less than 2 μm. The difference between average GC-IPL thickness and minimum GC-IPL thickness was 2.3 μm (± 1.9; 5th and 95th percentiles were 0.0 and 6.0 μm). The difference between the thickest and thinnest sector within eye was 6.4 μm (± 2.2; 5th and 95th percentiles were 3.0 and 10.0 μm). There was a moderate correlation in the difference between the nasal combined and the temporal combined sectors within eye pairs (p < 0.0001, Spearman’s ρ 0.58). The average GC-IPL thickness was weakly positively correlated with SE (spherical equivalent; combined sphere and ½ cylinder) (p = 0.031, Spearman’s ρ 0.23). Conclusions This study provides normative GC-IPL thickness values for healthy 6.5 year- old Swedish children. The GC-IPL thickness variations within eyes and within eye pairs are generally small. It could therefore be assumed that larger variations are sensitive markers of focal GC-IPL thinning due to damage to the primary visual pathways in children.
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Affiliation(s)
- Urszula Arnljots
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Maria Nilsson
- Department of Clinical Neuroscience, Unit of Optometry, Karolinska Institutet, Stockholm, Sweden
| | - Ida Hed Myrberg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Åden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Hellgren
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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12
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Nuijts MA, Degeling MH, Stegeman I, Schouten-van Meeteren AYN, Imhof SM. Visual impairment in children with a brain tumor: a prospective nationwide multicenter study using standard visual testing and optical coherence tomography (CCISS study). BMC Ophthalmol 2019; 19:220. [PMID: 31706271 PMCID: PMC6842490 DOI: 10.1186/s12886-019-1225-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/23/2019] [Indexed: 01/11/2023] Open
Abstract
Background Children with a brain tumor have a high risk of impaired vision. Up to now, visual acuity measurement, visual field testing and orthoptic testing are the most informative diagnostic investigations for the assessment of visual function. Evaluating vision in children can be challenging given the challenges in cooperation, concentration and age-dependent shifts in visual tests. Since visual loss due to a brain tumor can be progressive and irreversible, we must aim to detect visual impairment as early as possible. Several studies have shown that optical coherence tomography facilitates discovery of nerve fiber damage caused by optic nerve glioma. Consequently, early detection of potential ocular damage will effect treatment decisions and will provide timely referral to visual rehabilitation centers. Methods/design The CCISS study is a prospective, observational, multicenter cohort study in The Netherlands. Patients aged 0–18 years with a newly diagnosed brain tumor are invited for inclusion in this study. Follow-up visits are planned at 6, 12, 18 and 24 months. Primary endpoints are visual acuity, visual field and optical coherence tomography parameters (retinal nerve fiber layer thickness and ganglion cell layer – inner plexiform layer thickness). Secondary endpoints include the course of visual function (measured by visual acuity, visual field and optical coherence tomography at different follow-up visits), course of the disease and types of treatment. Discussion The CCISS study will heighten the awareness of visual impairment in different types of brain tumors in children. This study will show whether optical coherence tomography leads to earlier detection of visual impairment compared to standard ophthalmological testing (i.e. visual acuity, visual field testing) in children with a brain tumor. Furthermore, the systematic approach of ophthalmological follow-up in this study will give us insight in the longitudinal relation between the course of visual function, course of the disease and types of treatment in children with a brain tumor. Trial registration The CCISS study is prospectively registered in the Netherlands Trial Register (NTR) since April 2019. Identifier: NL7697.
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Affiliation(s)
- M A Nuijts
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Room E 03.136, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands.
| | - M H Degeling
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - I Stegeman
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - S M Imhof
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
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13
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Muñoz-Gallego A, Rodríguez-Salgado M, de la Cruz J, López-López C, Cañas-Zamarra I, Tejada-Palacios P. Paediatric optical coherence tomography normative databases: A real need. ACTA ACUST UNITED AC 2019; 94:591-597. [PMID: 31685301 DOI: 10.1016/j.oftal.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Optical coherence tomography (OCT) has become an essential tool in paediatric ophthalmology. However, none of the currently available OCT devices include any kind of normative database for the paediatric population, which can lead to important interpretation errors. OBJECTIVE To review the paediatric OCT normative databases. MATERIAL AND METHODS The applications and implications of the use of paediatric OCT normative databases are reviewed. RESULTS The paediatric normative databases that have been published so far in scientific literature with different OCT devices for Spanish and European population are presented. CONCLUSIONS The knowledge and interpretation of paediatric OCT normative databases in our daily clinical practice is crucial in order for the correct interpretation of OCT thickness maps.
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Affiliation(s)
- A Muñoz-Gallego
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España.
| | | | - J de la Cruz
- Instituto de investigación i+12. ISCIII, SAMID, Hospital Universitario 12 de Octubre, Madrid, España
| | - C López-López
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España
| | - I Cañas-Zamarra
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España
| | - P Tejada-Palacios
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España; Instituto de investigación i+12. ISCIII, SAMID, Hospital Universitario 12 de Octubre, Madrid, España
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Lambe J, Murphy OC, Saidha S. Can Optical Coherence Tomography Be Used to Guide Treatment Decisions in Adult or Pediatric Multiple Sclerosis? Curr Treat Options Neurol 2018; 20:9. [DOI: 10.1007/s11940-018-0493-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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15
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Cernichiaro-Espinosa LA, Tran KD, Berrocal AM. Imaging Modalities in Pediatric Vitreoretinal Disorders. CURRENT OPHTHALMOLOGY REPORTS 2018. [DOI: 10.1007/s40135-018-0159-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Optic Pathway Gliomas in Neurofibromatosis Type 1: An Update: Surveillance, Treatment Indications, and Biomarkers of Vision. J Neuroophthalmol 2017; 37 Suppl 1:S23-S32. [PMID: 28806346 DOI: 10.1097/wno.0000000000000550] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Optic pathway gliomas (OPGs) occur in 15%-20% of children with neurofibromatosis type 1 (NF1), leading to visual deficits in fewer than half of these individuals. The goal of chemotherapy is to preserve vision, but vision loss in NF1-associated OPG can be unpredictable. Determining which child would benefit from chemotherapy and, equally important, which child is better observed without treatment can be difficult. Unfortunately, despite frequent imaging and ophthalmologic evaluations, some children experience progressive vision loss before treatment. Indications for chemotherapy usually are based on a comprehensive, quantitative assessment of vision, but reliable vision evaluation can be challenging in young children with NF1-OPG. The ability to identify and predict impending vision loss could potentially improve management decisions and visual outcomes. To address this challenge, ophthalmologic, electrophysiologic, and imaging biomarkers of vision in NF1-OPG have been proposed. We review current recommendations for the surveillance of children at risk for NF1-OPG, outline guidelines for initiating therapy, and describe the utility of proposed biomarkers for vision.
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17
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Abstract
Few diseases blur the margins between their childhood and adult-onset varieties as much as optic neuritis. This report will review our state of knowledge of pediatric optic neuritis, as well as its relationship to the latest consensus definitions of neuroinflammatory disease. Current diagnostic and treatment options will be explored, as well as our potential to uncover an understanding of pediatric optic neuritis through systematic prospective studies. The risk of evolving multiple sclerosis is probably less than in adults, but pediatric optic neuritis is more likely to be an initial manifestation of acute disseminated encephalomyelitis. Steroids may hasten visual recovery, but they do not change visual outcome except in cases because of neuromyelitis optica. The role of puberty in modifying the presentation and risk associations is unknown. Prospective studies are required to resolve these diagnostic and management issues.
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18
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Mokbul MI. Optical Coherence Tomography: Basic Concepts and Applications in Neuroscience Research. J Med Eng 2017; 2017:3409327. [PMID: 29214158 PMCID: PMC5682075 DOI: 10.1155/2017/3409327] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/22/2017] [Accepted: 09/14/2017] [Indexed: 12/28/2022] Open
Abstract
Optical coherence tomography is a micrometer-scale imaging modality that permits label-free, cross-sectional imaging of biological tissue microstructure using tissue backscattering properties. After its invention in the 1990s, OCT is now being widely used in several branches of neuroscience as well as other fields of biomedical science. This review study reports an overview of OCT's applications in several branches or subbranches of neuroscience such as neuroimaging, neurology, neurosurgery, neuropathology, and neuroembryology. This study has briefly summarized the recent applications of OCT in neuroscience research, including a comparison, and provides a discussion of the remaining challenges and opportunities in addition to future directions. The chief aim of the review study is to draw the attention of a broad neuroscience community in order to maximize the applications of OCT in other branches of neuroscience too, and the study may also serve as a benchmark for future OCT-based neuroscience research. Despite some limitations, OCT proves to be a useful imaging tool in both basic and clinical neuroscience research.
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Affiliation(s)
- Mobin Ibne Mokbul
- Notre Dame College, Motijheel Circular Road, Arambagh, Motijheel, Dhaka 1000, Bangladesh
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19
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Rubegni A, Pisano T, Bacci G, Tessa A, Battini R, Procopio E, Giglio S, Pasquariello R, Santorelli FM, Guerrini R, Nesti C. Leigh-like neuroimaging features associated with new biallelic mutations in OPA1. Eur J Paediatr Neurol 2017; 21:671-677. [PMID: 28442211 DOI: 10.1016/j.ejpn.2017.04.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 04/10/2017] [Indexed: 12/13/2022]
Abstract
Behr syndrome is characterized by the association of early onset optic atrophy, cerebellar ataxia, pyramidal signs, peripheral neuropathy and mental retardation. Recently, some cases were reported to be caused by biallelic mutations in OPA1. We describe an 11-year-old girl (Pt1) and a 7-year-old boy (Pt2) with cognitive delay, ataxic gait and clinical signs suggestive of a peripheral neuropathy, with onset in early infancy. In Pt1 ocular fundus examination revealed optic disk pallor whereas Pt2 exhibited severe optic atrophy. In both children neuroimaging detected a progressive cerebellar involvement accompanied by basal ganglia hyperintensities and pathological peak levels of lactate. In both patients, muscle biopsy showed diffuse reduction of cytochrome c oxidase stain, some atrophic fibers and type II fiber grouping. Using a targeted resequencing panel in next generation sequencing, we identified the homozygous c.1180G>A/p.Ala394Thr mutation in Pt1 and the c.2779-2A>C mutation in compound heterozygosity with the c.2809C>T/p.Arg937Cys mutation in Pt2. All variants were novel and segregated in the healthy parents. Expression of OPA1 protein was significantly reduced in muscle tissues of both patients by Western blotting. We also observed in patients' fibroblasts a higher proportion of fragmented and intermediate mitochondria upon galactose treatment compared to controls, as already seen in other patients harboring mutations in OPA1. The presence of Leigh-like neuroimaging features is a novel finding in Behr syndrome and further adds to the complex genotype-phenotype correlations in OPA1-associated disorders.
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Affiliation(s)
- Anna Rubegni
- Molecular Medicine, IRCCS Stella Maris, Pisa, Italy
| | - Tiziana Pisano
- Pediatric Neurology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Italy
| | - Giacomo Bacci
- Pediatric Ophthalmology, Children's Hospital A. Meyer-University of Florence, Italy
| | | | | | - Elena Procopio
- Metabolic and Neuromuscular Unit, Children's Hospital A. Meyer-University of Florence, Italy
| | - Sabrina Giglio
- Medical Genetics, Children's Hospital A. Meyer-University of Florence, Italy
| | | | | | - Renzo Guerrini
- Pediatric Neurology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Italy.
| | - Claudia Nesti
- Molecular Medicine, IRCCS Stella Maris, Pisa, Italy.
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Gospe SM, Bhatti MT, El-Dairi MA. Emerging Applications of Optical Coherence Tomography in Pediatric Optic Neuropathies. Semin Pediatr Neurol 2017; 24:135-142. [PMID: 28941529 DOI: 10.1016/j.spen.2017.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Limited cooperation and attention span often lead to poorly reliable assessments of visual acuity and visual fields in children, making diagnosis and monitoring of pediatric optic neuropathies challenging. As a noninvasive imaging modality, optical coherence tomography (OCT) could offer particular utility in this patient population. OCT provides high-resolution characterization of the optic nerve head, peripapillary retinal nerve fiber layer, and cellular layers of the macula, all of which can be used to assess the severity of optic nerve disease qualitatively and quantitatively. Application of OCT to pediatric patients has been limited by technical factors and lack of pediatric normative databases, but with recent technological improvements and rapidly expanding research efforts OCT is poised to revolutionize the management of optic neuropathies in children. We review current and emerging applications of OCT to important pediatric optic neuropathies such as glaucoma, papilledema, optic neuritis, optic pathway gliomas, and congenital optic disc anomalies.
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Affiliation(s)
- Sidney M Gospe
- From the (*)Department of Ophthalmology, Duke University Medical Center, Durham, NC
| | - M Tariq Bhatti
- From the (*)Department of Ophthalmology, Duke University Medical Center, Durham, NC; (†)Department of Neurology, Duke University Medical Center, Durham, NC; (‡)Department of Neurosurgery, Duke University Medical Center, Durham, NC
| | - Mays A El-Dairi
- (‡)Department of Neurosurgery, Duke University Medical Center, Durham, NC.
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21
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Strabologische und neuroophthalmologische Aspekte kindlicher Tumorerkrankungen. Ophthalmologe 2016; 113:557-69. [DOI: 10.1007/s00347-016-0289-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Origlieri C, Geddie B, Karwoski B, Berl MM, Elling N, McClintock W, Alexander J, Bazemore M, de Beaufort H, Hutcheson K, Miller M, Taylormoore J, Jaafar MS, Madigan W. Optical coherence tomography to monitor vigabatrin toxicity in children. J AAPOS 2016; 20:136-40. [PMID: 27079594 DOI: 10.1016/j.jaapos.2015.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 10/16/2015] [Accepted: 10/20/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The antiepileptic drug vigabatrin is known to cause permanent loss of vision. Both visual field testing and electroretinogram are used to detect retinal damage. Adult data on optical coherence tomography (OCT) shows that retinal nerve fiber layer (RNFL) thinning may be an early indicator of vigabatrin-induced retinal toxicity. The purpose of this study was to investigate whether OCT can detect early vigabatrin-induced retinal toxicity in children. METHODS Pediatric patients (≤18 years of age) requiring vigabatrin for seizure control who were followed at our institution were invited to participate. Patients were examined according to manufacturer guidelines, with most examinations taking place under general anesthesia. RNFL thickness was measured by OCT (Stratus Model 3000, Zeiss) and compared to total cumulative dose of vigabatrin. In most cases, indirect ophthalmoscopy, fundus photography, and electroretinography were also performed. RESULTS OCT and complete dosing data was available for 19 patients. Patients with tuberous sclerosis (TS, n = 12) received higher cumulative doses (mean, 1463 g) than non-TS patients (mean, 351 g, P = 0.044). RNFL thinning was detected in the nasal (P < 0.01), superior (P < 0.01), and inferior (P < 0.05) quadrants in patients with TS, particularly once cumulative dose exceeded 1500 g. CONCLUSIONS In our study population of patients with TS, higher cumulative doses of vigabatrin were associated with RNFL thinning in the nasal, superior, and inferior quadrants. These findings were pronounced once cumulative dose exceeded 1500 g. This pattern of RNFL thinning is similar to what has been shown in adult patients taking vigabatrin.
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Affiliation(s)
| | - Brooke Geddie
- Helen DeVos Children's Hospital, Grand Rapids, Michigan
| | - Bethany Karwoski
- Children's National Health System, Washington, District of Columbia
| | - Madison M Berl
- Children's National Health System, Washington, District of Columbia
| | - Nancy Elling
- Children's National Health System, Washington, District of Columbia
| | | | | | - Marlet Bazemore
- Children's National Health System, Washington, District of Columbia
| | | | | | - Marijean Miller
- Children's National Health System, Washington, District of Columbia
| | | | - Mohamad S Jaafar
- Children's National Health System, Washington, District of Columbia
| | - William Madigan
- Children's National Health System, Washington, District of Columbia
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Avery RA, Cnaan A, Schuman JS, Trimboli-Heidler C, Chen CL, Packer RJ, Ishikawa H. Longitudinal Change of Circumpapillary Retinal Nerve Fiber Layer Thickness in Children With Optic Pathway Gliomas. Am J Ophthalmol 2015; 160:944-952.e1. [PMID: 26231306 DOI: 10.1016/j.ajo.2015.07.036] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 07/23/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate longitudinal changes in circumpapillary retinal nerve fiber layer (RNFL) thickness, as measured by spectral-domain optical coherence tomography (SD OCT), in children with optic pathway gliomas. DESIGN Longitudinal cohort study. METHODS Global and quadrant-specific circumpapillary RNFL thickness measures were acquired using either a hand-held SD OCT during sedation or a table-top SD OCT in children old enough to cooperate. Vision loss was defined as either a 0.2 logMAR decline in visual acuity or progression of visual field. Percent change in circumpapillary RNFL thickness in eyes experiencing vision loss was compared to eyes with stable vision. RESULTS Fifty-five eyes completed 250 study visits. Ten eyes (18%) from 7 patients experienced a new episode of vision loss during the study and 45 eyes (82%) from 39 patients demonstrated stable vision across study visits. Percent decline of RNFL thickness between the baseline visit and first event of vision loss event was greatest in the superior (-14%) and inferior (-10%) quadrants as well as global average (-13%). Using a threshold of ≥10% decline in RNFL, the positive and negative predictive value for vision loss when 2 or more anatomic sectors were affected was 100% and 94%, respectively. CONCLUSIONS Children experiencing vision loss from their optic pathway gliomas frequently demonstrate a ≥10% decline of RNFL thickness in 1 or more anatomic sectors. Global average and the inferior quadrant demonstrated the best positive and negative predictive values. Circumpapillary RNFL is a surrogate marker of vision and could be helpful in making treatment decisions for children with optic pathway gliomas.
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