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

Myrthe A Nuijts; Inge Stegeman; Giorgio L Porro; Carlien A M Bennebroek; Tom van Seeters; Frank A Proudlock; Antoinette Y N Schouten-van Meeteren; Saskia M Imhof

doi:10.1111/aos.15650

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

Acta Ophthalmol. 2023 Sep;101(6):658-669. doi: 10.1111/aos.15650. Epub 2023 Mar 16.

Authors

Myrthe A Nuijts¹, Inge Stegeman^{1

2

3}, Giorgio L Porro¹, Carlien A M Bennebroek⁴, Tom van Seeters⁵, Frank A Proudlock⁶, Antoinette Y N Schouten-van Meeteren⁷, Saskia M Imhof¹

Affiliations

¹ Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands.
² Department of Otorhinolaryngology and Head & Neck Surgery University, University Medical Centre Utrecht, Utrecht, The Netherlands.
³ Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.
⁴ Department of Ophthalmology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands.
⁵ Department of Radiology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
⁶ University of Leicester Ulverscroft Eye Unit, Leicester, UK.
⁷ Department of Neuro-Oncology, Princess Máxima Centre for Paediatric Oncology, Utrecht, The Netherlands.

PMID: 36924320
DOI: 10.1111/aos.15650

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.

Keywords: adolescent; brain tumour; child; optical coherence tomography; visual acuity; visual field; visual function.

MeSH terms

Child
Cohort Studies
Cross-Sectional Studies
Female
Humans
Male
Prospective Studies
Retinal Ganglion Cells* / pathology
Tomography, Optical Coherence* / methods
Vision Disorders / pathology

Abstract

MeSH terms

Grants and funding