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Visual function assessed by visually evoked potentials in optic pathway low-grade gliomas with and without neurofibromatosis type 1

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Abstract

Purpose

To investigate the contribution of full-field transient pattern-reversal visually evoked potentials (PRVEP) on cross-sectional evaluations of visual function in patients with and without neurofibromatosis type 1 (NF1) affected by optic pathway low-grade gliomas (OPLGG).

Methods

Participants were children and adolescents referred for visual function evaluation and receiving treatment for OPLGG, linked (NF1-OPLGG) or not to NF1 (Non-NF1-OPLGG). An age-adjusted control group was included for comparison. Monocular full-field PRVEPs were recorded from each eye in accordance with ISCEV standards. Parameters of peak-to-peak P100 amplitude (µV) and P100 peak time (ms) were measured. Cutoff normative values obtained from controls for 15′ and 60′ check sizes were ≥ 9.0 µV for N75-P100 amplitude and ≤ 103.0 ms for P100 peak time. The association of age, gender, tumor resection and NF1 with P100 amplitude reduction and P100 peak time delay was explored by Firth logistic regression modeling.

Results

Participants were 30 patients (15 males, 60% Non-NF1) with ages from 3.6 to 19.9 years (mean ± SD = 9.2 ± 3.8 years; median = 8.4 years) and 19 controls (12 males) with ages from 3.7 to 19.9 years (mean ± SD = 10.4 ± 4.9 years; median = 9.5 years). Overall, 68% of tested eyes presented reduced P100 amplitudes for both check sizes (46% in the NF-1 and 83% in the Non-NF1) and delayed P100 for both check sizes (38% in NF1 and 89% in Non-NF1). Absence of NF1 adjusted for age, gender and tumor resection was significantly associated with marginally reduced P100 amplitude for 15′ checks [odds ratio (OR): 6.26; 95% confidence interval (CI) = 0.96–40.94; p = 0.055].

Conclusions

Full-field PRVEP on cross-sectional evaluations contributed to detect visual dysfunction in two-thirds of patients with OPLGG by highlighting subclinical evidence of visual loss. Abnormalities were more frequent and more severe in OPLGG not linked to NF1 than in NF1-OPLGG; however, there was a difference in surgical management between these groups. PRVEP parameters may provide reliable evidence of visual pathway involvement in OPLGG, helping to hasten treatment before optic atrophy is detected.

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Authors and Affiliations

  1. Laboratório de Eletrofisiologia Visual Clínica, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, R. Botucatu 821, São Paulo, SP, 04023-062, Brazil

    Patrícia de Freitas Dotto, Adriana Berezovsky, Paula Yuri Sacai, Arthur Gustavo Fernandes, Daniel Martins Rocha & Solange Rios Salomão

  2. Programa de Neuro-Oncologia, Instituto de Oncologia Pediátrica, Grupo de Apoio ao Adolescente e à Criança com Câncer (IOP-GRAAC), Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil

    Andrea Maria Cappellano, Nasjla Saba da Silva & Frederico Adolfo B. Silva

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  1. Patrícia de Freitas Dotto
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  2. Adriana Berezovsky
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Correspondence to Solange Rios Salomão.

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Dotto, P.F., Berezovsky, A., Cappellano, A.M. et al. Visual function assessed by visually evoked potentials in optic pathway low-grade gliomas with and without neurofibromatosis type 1. Doc Ophthalmol 136, 177–189 (2018). https://doi.org/10.1007/s10633-018-9635-0

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