Abstract
PurposeTo determine the ability of Saccadic Vector Optokinetic Perimetry (SVOP) to detect and characterise visual field defects in children with brain tumours using eye-tracking technology, as current techniques for assessment of visual fields in young children can be subjective and lack useful detail.MethodsCase-series study of children receiving treatment and follow-up for brain tumours at the Royal Hospital for Sick Children in Edinburgh from April 2008 to August 2013. Patients underwent SVOP testing and the results were compared with clinically expected visual field patterns determined by a consensus panel after review of clinical findings, neuroimaging, and where possible other forms of visual field assessment.ResultsSixteen patients participated in this study (mean age of 7.2 years; range 2.9–15 years; 7 male, 9 female). Twelve children (75%) successfully performed SVOP testing. SVOP had a sensitivity of 100% and a specificity of 50% (positive predictive value of 80% and negative predictive value of 100%). In the true positive and true negative SVOP results, the characteristics of the SVOP plots showed agreement with the expected visual field. Six patients were able to perform both SVOP and Goldmann perimetry, these demonstrated similar visual fields in every case.ConclusionSVOP is a highly sensitive test that may prove to be extremely useful for assessing the visual field in young children with brain tumours, as it is able to characterise the central 30° of visual field in greater detail than previously possible with older techniques.
Highlights
Central nervous system (CNS) tumours are the commonest solid tumours of childhood and the most common cause of childhood cancer death
Objective visual field testing is valuable in demonstrating stability or progression of a tumour, if the tumour involves the anterior visual pathway, and if visual field changes are corroborated by MRI appearances effective clinical management decisions can be made
● Assessment of visual fields is an important component of the assessment of visual pathway tumours in peadiatric neuro-oncology
Summary
Central nervous system (CNS) tumours are the commonest solid tumours of childhood and the most common cause of childhood cancer death. Current strategies for children with brain tumours aim to maintain survival rates with minimal treatment related longterm sequelae. Their management requires multidisciplinary team (MDT) input in treatment and monitoring [3]. These children commonly have visual field defects not reported by the child nor recognised by the care-giver [4]. When tumours involve the visual pathways, preservation of vision becomes a treatment objective. Objective visual field testing is valuable in demonstrating stability or progression of a tumour, if the tumour involves the anterior visual pathway, and if visual field changes are corroborated by MRI appearances effective clinical management decisions can be made. Visual field information allows practical advice to be provided to assist a child’s daily living
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