Clinical Ophthalmology (Sep 2022)

Visual Outcome for Children with Optic Pathway Gliomas Treated with Systemic Chemotherapy

  • Mohammad M,
  • Alrawashdeh HM,
  • Mehyar M,
  • Amayiri N,
  • Abu Laban D,
  • Alnawaiseh I,
  • Yousef Y

Journal volume & issue
Vol. Volume 16
pp. 2933 – 2942

Abstract

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Mona Mohammad,1,* Hamzeh Mohammad Alrawashdeh,2,* Mustafa Mehyar,1 Nisreen Amayiri,3 Dima Abu Laban,4 Ibrahim Alnawaiseh,1 Yacoub Yousef1 1Department of Surgery, Division of Ophthalmology, King Hussein Cancer Center (KHCC), Amman, Jordan; 2Department of Ophthalmology, Sharif Eye Centers, Irbid, Jordan; 3Department of Pediatric Oncology, King Hussein Cancer Center (KHCC), Amman, Jordan; 4Department of Diagnostic Radiology, King Hussein Cancer Center (KHCC), Amman, Jordan*These authors contributed equally to this workCorrespondence: Mona Mohammad; Yacoub Yousef, Department of Surgery, Division of Ophthalmology, King Hussein Cancer Center, P.O. Box 1269, Amman, 11941, Jordan, Tel +962 795372321 ; +962 79 100 3333, Fax +962 6 5345 567, Email [email protected]; [email protected]: This study aims to report visual acuity outcomes for patients with optic pathway gliomas (OPG) treated with systemic chemotherapy and analyze the associated factors.Patients and Methods: A retrospective study of 29 children with OPG treated with chemotherapy at King Hussein Cancer Center (KHCC), Amman, Jordan, between May/2005 and August/2020. Details on patient demographics, tumor location, systemic chemotherapy, and progression of disease were extracted from medical records.Results: Fifty-four eyes of twenty-nine patients were included in this study with a follow-up range from 2 to 17 years. Sixteen patients (55%) had a history of neurofibromatosis-1 (NF1). Most of the eyes (31, 57%) had visual acuity ranges in the moderate or better group. The age group ≥ 5 years at diagnosis, those with hydrocephalus, and patients with non-NF1 presented the worst visual acuity ranges from severe or worse; the p-value was 0.043, 0.0320, and 0.0054, respectively. Following treatment with systemic chemotherapy, visual acuity improved in 5 (17%) patients, remained the same in 23 (79%) patients, and only one patient (3%) had vision deterioration. Of the five patients who showed vision improvement, only one had radiological regression of the tumor. Parallel to this, three (10%) patients showed tumor progression in the final magnetic resonance image (MRI) findings without affecting the final vision.Conclusion: Children older than 5 years at diagnosis, in sporadic OPG, and those with hydrocephalus had the worst vision at presentation. Treatment with systemic chemotherapy prevented further deterioration of vision, and following treatment with systemic chemotherapy, most of the patients had the same vision; this stability indicates that vision at diagnosis is an important predictor for the final visual outcome.Keywords: glioma, neurofibromatosis, neuro-oncology, pediatric tumors, vision

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