Abstract
Purpose :
Vision loss is the primary symptom of Pediatric optic neuritis (PON), and visual function assessment is one of the important indicators for evaluating treatment effects. Children have poor cooperation and low reliability in visual function assessment. This study utilized Optical coherence tomography (OCT) to quantitatively evaluate the change of RNFL in children with PON and analyzed its clinical significance in prognosis of VA.
Methods :
A total of 63 children (106 eyes) with PON and 58 (107 eyes) age-sex matched healthy children as controll were enrolled in this study. OCT examination and visual acuity assessment was performed on each child on both the onset and 6-months follow-up of PON. The receiver operating characteristic (ROC) curve was applied to analyze the structure change of RNFL in visual prognosis assessment. All data were analyzed statistically using SSPS.17.0.
Results :
63 children with PON, 34 males and 29 females (10.3±3.3 yrs）were enrolled. The prognostic visual acuity was logMar0.39±0.34. The thickness of the peripapillary nerve fiber layer (pRNFL), macular ganglion cell and inner plexiform layer (mGCIP), and inner nuclear layer (mINL) in eyes with PON were compared with control. In addition to thickening of the mINL (p=0.000), The remaining layers were significantly thinner (p=0.000, p=0.000, p=0.000). Among them, pRNFL and mGCIP layers had the best linear correlation with prognostic visual acuity. ROC curve analysis found that when the pRNFL thickness decreased to 89.5 μm (AUC=0.973, P=0.000) or the mGCIP volume decreased to 1.89mm3 (AUC=0.982, P=0.000), it was suggested that ON had occurred; when the pRNFL thickness decreased to 60.5μm (AUC=0.643, P=0.013) or the mGCIP volume decreased to 1.41mm3 (AUC=0.636, P=0.018), it indicated that the prognostic VA was lower than 1.0; when the pRNFL thickness decreased to 58.5 μm (AUC=0.800, P= 0.002) or the mGCIP volume decreased to 1.37mm3 (AUC=0.856, P=0.000), the prognostic VA was 0.5; when the pRNFL thickness decreased to 45.5μm (AUC=0.932, P=0.000) or the mGCIP volume decreased to 1.16mm3 (AUC=0.942, P=0.001), it indicated that the prognostic VA was lower than 0.1.
Conclusions :
Children with optic neuritis have poor cooperation and low reliability in vision examination. The assessment of optic nerve structural damage by OCT is of great value in the diagnosis and prognosis of PON.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.