Abstract
PurposeTo systematically review the evidence on the diagnostic accuracy and prognostic value of retinal optical coherence tomography (OCT) to detect visual acuity (VA) or visual field (VF) loss in children with a brain tumour.MethodsPubMed, Embase and Cochrane Library databases were searched from inception to February 2021. We included studies evaluating retinal OCT and standard visual function parameters (VA and or VF) in children with a brain tumour. Two authors independently extracted data from each included study. They also assessed the methodological quality of the studies using the QUADAS-2 or QUIPS tool. The diagnostic accuracy of OCT was evaluated with receiver operating characteristic analysis, sensitivity, specificity, positive predictive value and negative predictive value. The prognostic value of OCT was evaluated with predictive measures (odds ratio).ResultsWe included five diagnostic studies, with a total of 186 patients, all diagnosed with optic pathway glioma. No prognostic studies were eligible for inclusion. Included studies evaluated either retinal nerve fiber layer (RNFL) thickness or ganglion cell layer—inner plexiform layer (GCL-IPL) thickness. There was considerable heterogeneity between OCT devices, OCT protocols, visual function parameters and threshold values. Sensitivity and specificity for RNFL thickness measurement ranged from 60.0% to 100.0% and 76.6% to 100%, respectively. For GCL-IPL thickness measurement, area under the curve ranged from 0.91 to 0.98 for different diameters.ConclusionThe literature regarding the diagnostic accuracy and prognostic value of OCT parameters in children with a brain tumour is scarce. Due to heterogeneity and a considerable risk of bias of included studies, we cannot draw solid conclusions regarding the accuracy of retinal OCT. Future research should investigate the potential of OCT as diagnostic and prognostic tool for the evaluation of the visual function and detection of visual impairment in children with any type of brain tumour.
Highlights
Optical coherence tomography (OCT) is a non-invasive, in vivo, imaging modality which provides high-resolution cross-sectional images of ocular tissues by using low-coherence interferometry [1, 2]
Sensitivity and specificity for retinal nerve fiber layer (RNFL) thickness measurement ranged from 60.0% to 100.0% and 76.6% to 100%, respectively
Due to heterogeneity and a considerable risk of bias of included studies, we cannot draw solid conclusions regarding the accuracy of retinal OCT
Summary
Optical coherence tomography (OCT) is a non-invasive, in vivo, imaging modality which provides high-resolution cross-sectional images of ocular tissues by using low-coherence interferometry [1, 2]. There has been increasing information about the diagnostic and prognostic ability of RNFL and GCL-IPL thickness measurements for the detection of visual acuity (VA) and VF loss in children with a brain tumour. This applies to children with a brain tumour located along the visual pathway, including low-grade gliomas, craniopharyngiomas and germ cell tumours [3, 9,10,11,12,13,14,15]. Early detection of impaired visual function and timely initiation of treatment or referral for visual rehabilitation are important to preserve visual function and improve coping in daily life [18, 19]
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