Visual Acuity Outcomes in Children With Optic Nerve Hypoplasia and Septo-Optic-Pituitary Dysplasia

Michael S Salman; Shakhawat Hossain; Elizabeth Carson; Chelsea A Ruth; Ian H Clark

doi:10.1016/j.pediatrneurol.2023.09.018

Visual Acuity Outcomes in Children With Optic Nerve Hypoplasia and Septo-Optic-Pituitary Dysplasia

Pediatr Neurol. 2023 Dec:149:167-175. doi: 10.1016/j.pediatrneurol.2023.09.018. Epub 2023 Sep 29.

Authors

Michael S Salman¹, Shakhawat Hossain², Elizabeth Carson³, Chelsea A Ruth⁴, Ian H Clark⁵

Affiliations

¹ Section of Pediatric Neurology, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: msalman@hsc.mb.ca.
² Department of Mathematics and Statistics, University of Winnipeg, Winnipeg, Manitoba, Canada.
³ Pediatric Ophthalmology, Children's Hospital, Health Science Centre, Winnipeg, Manitoba, Canada.
⁴ Section of Neonatology, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
⁵ Section of Pediatric Ophthalmology, Department of Ophthalmology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

PMID: 38557645
DOI: 10.1016/j.pediatrneurol.2023.09.018

Abstract

Background: To investigate best-corrected visual acuity (BCVA) outcomes in patients with optic nerve hypoplasia (ONH)/septo-optic-pituitary dysplasia (SOD). Our primary hypothesis was that BCVA in patients with ONH/SOD does not change significantly over time.

Methods: A chart review was undertaken in patients with a confirmed diagnosis of ONH/SOD. Demographic and clinical ophthalmologic data were extracted. Quantitative BCVA data were investigated across clinic visits after converting acuities to the logarithm of the minimum angle of resolution (logMAR).

Results: There were 102 patients (56 males). Median age at the end of the study was 12.7 years. Median duration of follow-up was 4.5 years. BCVA significantly worsened slightly in the most affected eyes (0.056 average increase in logMAR/year, 95% confidence interval [CI]: 0.037 to 0.075) and significantly improved mildly in the lesser or equally affected eyes (0.014 average decrease in logMAR/year, 95% CI: 0.009 to 0.019) (P < 0.0001).

Conclusions: Although the overall BCVA data showed a statistically significant change with time, the actual changes were small and are of doubtful meaningful clinical significance (less than one line change on a Snellen chart). Our data suggest that ONH/SOD are nonprogressive neurodevelopmental disorders. The mild worsening of BCVA in the most affected eyes may be caused by amblyopia, whereas the small improvement in the lesser or equally affected eyes may be caused by developmental maturation. In addition, the changes in BCVA may also be due to increasing reliability of visual assessments with increasing age.

Keywords: Optic nerve hypoplasia; Outcome; Pediatrics; Visual acuity.

MeSH terms

Child
Humans
Male
Optic Nerve / diagnostic imaging
Optic Nerve Hypoplasia*
Pituitary Diseases*
Reproducibility of Results
Retrospective Studies
Visual Acuity