Decreased GCL-IPL thickness (

Purpose To determine the intra- and inter-visit reproducibility of ganglion cell-inner plexiform layer thickness measures using handheld optical coherence tomography (OCT) in sedated children with optic pathway gliomas and/or Neurofibromatosis type 1 (NF1). Design Prospective longitudinal cohort study Methods Children with sporadic optic pathway gliomas and/or NF1 who had ≥ 2 volumes acquired over the macula using handheld OCT during sedation for a clinically indicated MRI were eligible for the intra-visit cohort. Children with repeat handheld OCT imaging within 6 months were eligible for the inter-visit cohort. Total retinal thickness and ganglion cell-inner plexiform layer thickness were measured using custom designed automated segmentation software. Reproducibility was compared across average and anatomic quadrant by calculating the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Results Forty-two subjects (median age 5.4 years, range 0.8–12.7 years) contributed 45 eyes to the intra-visit cohort. Thirty-one subject eyes had normal vision and 14 had abnormal vision (decreased visual acuity and/or visual field). Average and quadrant ganglion cell-inner plexiform layer measures demonstrated CVs ≤ 4.5% with excellent ICCs (> .935). The superior quadrant CV differed between subjects with (4.4%) and without (2.1%) vision loss (P < 0.05). Twenty-five subject eyes were eligible for the inter-visit cohort, demonstrating CVs from 1.6% to 5.2%. Inter-visit ICCs were excellent (.955 – .995). Discussion Handheld OCT imaging in sedated children with optic pathway gliomas produces highly reproducible measures of ganglion cell-inner plexiform layer thickness.

Purpose To determine the intra- and intervisit reproducibility of circumpapillary retinal nerve fiber layer (RNFL) measures using handheld optical coherence tomography (OCT) in sedated children. Design Prospective cross-sectional and longitudinal study Methods Children undergoing sedation for a clinically indicated MRI for an optic pathway glioma and or Neurofibromatosis type 1 (NF1) had multiple 6 × 6 mm volumes (isotropic 300×300 or non-isotropic 1000×100 samplings) acquired over the optic nerve. Children with two handheld OCT sessions within 6 months were included in the intervisit cohort. The intra- and inter-visit coefficient of variation (CV) and intraclass correlation coefficient (ICC) were calculated for the average and anatomic quadrant circumpapillary RNFL thickness. Results Fifty-nine subjects (mean age 5.1 years, range 0.8–13.0 years) comprised the intravisit cohort and 29 subjects (mean age 5.7 years, range 1.8–12.7 years) contributed to the intervisit cohort. Forty-nine subjects had an optic pathway glioma and 10 subjects had NF1 without an optic pathway glioma. The CV was comparable regardless of imaging with an isotropic and non-isotropic volume in both the intra- and intervisit cohorts. The average circumpapillary RNFL demonstrated the lowest CV and highest ICC compared to the quadrants. For the intervisit cohort, the average ICC was typically higher while the CV was typically lower, but not statistically different compared to the other quadrants. Discussion Circumpapillary RNFL measures acquired with handheld OCT during sedation demonstrate good intra- and intervisit reproducibility. Handheld OCT has the potential to monitor progressive optic neuropathies in young children who have difficulty cooperating with traditional OCT devices.

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