Abstract
Purpose :
Visual field (VF) loss is highly prevalent in children with optic pathway gliomas (OPGs). In spite of this, data regarding test-retest reproducibility of Goldmann visual field (GVF) testing are lacking, yet this information is critical towards determining VF stability versus progression in children with OPGs. The purpose of this study is to report on the inter-visit test-retest reproducibility of GVF testing in pediatric patients with OPGs.
Methods :
Children (<18 years) with NF1- and sporadic-OPGs who were enrolled in a prospective longitudinal study of visual biomarkers from 3 institutions were eligible for inclusion. Standardized GVF protocol and visual acuity (VA) assessments were performed in stable patients who were not on chemotherapy at the time of the study. VF characteristics including extent by meridian in degrees (15, 45, 60, 75, 105, 120, 135, 165, 195, 225, 240, 255, 285, 300, 315, 345 degrees) were compared between two visits in stable patients. Patients were tested with two of three isopters (V4e, III4e, I4e). The impact of NF1 status, age, sex, inter-visit interval, tumor extent, and VA on test-retest reproducibility were assessed.
Results :
Fifty-six subjects met inclusion criteria (43% female, 66% NF1-associated). Mean subject age at the first visit was 10.4 years (SD 3.9 years). For the V4e target size (13 subjects), the mean inter-visit difference was 2.1 degrees (range SD 5.1-14.4). For the III4e target size (54 subjects), the mean inter-visit difference was 1.7 degrees (range SD 6.5-12.0). For the I4e target size (42 subjects), the mean inter-visit difference was 0.8 (range SD 6.5-11.8). There was no meridian with a statistically significant mean difference between visits. Multivariable analysis revealed no association between test-retest reproducibility and NF1 status, age at first visit, inter-visit interval, visual acuity, or target size (all p>0.05). Male sex was associated with less reproducibility than female sex (p=0.030).
Conclusions :
GVF testing in pediatric patients with OPGs is reproducible using a standardized protocol. We did not find significant variability for any of the meridia tested. Defining inter-visit variability for GVF testing in these patients establishes normative data to determine whether or not tumor progression is present.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.