NEUROPHTHALMOLOGY Correlation of optical coherence tomography parameters with clinical and radiological progression in patients with symptomatic optic pathway gliomas Masoud Aghsaei Fard & Sara Fakhree & Bahram Eshraghi Received: 19 March 2013 / Revised: 16 May 2013 / Accepted: 20 May 2013 # Springer-Verlag Berlin Heidelberg 2013 Abstract Purpose To study the optical coherence tomography (OCT) characteristics in children with optic pathway glioma (OPG) to determine if OCT changes occur alongside clinical/radiological changes at diagnosis and during the second-year follow-up. Methods Twenty-three patients (38 eyes) diagnosed with symptomatic OPG in a single institution were enrolled in this longitudinal observational cohort study. Complete ophthalmo- logic evaluation, including determination of visual acuity, visu- al fields, retinal nerve fiber layer ,and posterior pole retinal thickness scanning with spectral-domain optical coherence to- mography, and neuroimaging was performed at the time of diagnosis and 6 months and 1 and 2 years after presentation. Patients who experienced visual decline or radioagraphic tumor enlargement of the OPG were classified as progressors. OCT data were compared between progressors and nonprogressors. Results The average age at diagnosis was 5.8 years. All pa- tients were followed up for 24 months. Five patients (21 %) (eight eyes) had clinical or radiological progression of their OPG during follow-up and were classified as progressors. Mean changes in average nerve fiber layer and posterior pole retinal thickness were significantly higher for progressors com- pared with nonprogressors (P <0.001). The area under the receiver operator characteristic curves comparing average nerve fiber layer and posterior pole retinal thinning between the progressors and nonprogressors were 0.94 and 0.95 respectively. Conclusions Optical coherence tomography of average nerve fiber layer and posterior pole retinal thickness may be helpful in monitoring OPG. Keyword Optic pathway glioma . Optical coherence tomography . Progression Introduction Optic pathway glioma (OPG) represents a form of low-grade glioma. OPGs are confined to the structures of the visual pathway and, histologically, they are almost uniformly pilocytic astrocytoma (WHO grade I). Children affected by neurofibromatosis type 1 (NF-1) are predisposed to the devel- opment of OPG [1]. Many of these tumors show prolonged indolent phases, while others progress rapidly and/or may have an erratic growth pattern. Spontaneous tumor regressions have also been documented [2–5]. Only OPGs that show growth potential or cause severe clinical symptoms are candi- dates for therapy [6]. Many different factors, such as age at diagnosis (or at start of treatment), tumor site along the optic pathway, and NF-1 status, have been suggested as possible predictors of tumor progression, specifically visual loss and/or neuroradiological tumor enlargement [7]. Sporadic gliomas occur in children without NF-1 and seem to be clinically more aggressive than NF-1 associated OPGs [6, 7]. The challenge is how to follow OPG to determine progression of the disease. Clinical examination, visually evoked potentials, and neuro- imaging can be used for following OPGs [6]. Difficulties of conducting vision test on young children are important issues, which rely heavily on the child’ s cooperation. Electronic supplementary material The online version of this article (doi:10.1007/s00417-013-2394-4) contains supplementary material, which is available to authorized users. M. A. Fard : S. Fakhree : B. Eshraghi Farabi Eye Research Center, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran M. A. Fard (*) Farabi Eye Research Center, Qazvin Sq, Tehran, Iran 13366-16351 e-mail: masood219@gmail.com Graefes Arch Clin Exp Ophthalmol DOI 10.1007/s00417-013-2394-4