Long-term visual acuity outcomes after radiation therapy for sporadic optic pathway glioma

Sahaja Acharya, Sophia Quesada, Kenneth Coca, Cody Richardson, Mary E. Hoehn, Jason Chiang, Ibrahim Qaddoumi, Frederick Boop, Amar Gajjar, Thomas E. Merchant

Research output: Contribution to journalArticle

Abstract

Purpose: Children with sporadic optic pathway glioma (OPG) commonly experience a decline in visual acuity (VA). This study aimed to quantify long-term VA outcomes after definitive radiation therapy (RT). Methods: From 1997 to 2017, 41 patients underwent RT for OPG and had baseline VA testing. All patients underwent serial VA testing every 3–6 months during the first 5 years and annually thereafter. The cumulative incidence of VA decline or improvement (per eye) was estimated using death as a competing risk. Results: Mean follow-up was 5 years. Most tumors (93%) involved the postchiasmatic optic tracts and/or hypothalamus. Of the tumors tested for BRAF alterations (n = 15), 67% had a BRAF fusion. Median time to VA decline was 20 months in the eye with worse vision and 22 months in the better eye. For the worse eye, the 5-year cumulative incidences of VA decline and improvement were 17.9% [95% confidence interval (CI) 7–32.8%] and 13.5% (95% CI 4.7–26.7%), respectively. For the better eye, the 5-year cumulative incidences of VA decline and improvement were 11.5% (95% CI 3.5–30.7%) and 10.6% (95% CI 2.6–25.2%), respectively. Visual outcomes did not correlate with radiographic evidence of tumor progression. Conclusions: The 5-year cumulative incidence of VA decline was low. VA decline is most likely to occur within the first 2 years after RT and is not associated with radiographic progression of disease, highlighting the need for frequent ophthalmologic exams during this period.

Original languageEnglish (US)
JournalJournal of Neuro-Oncology
DOIs
StateAccepted/In press - Jan 1 2019

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Optic Nerve Glioma
Visual Acuity
Radiotherapy
Radiation
Confidence Intervals
Incidence
Neoplasms
Hypothalamus
Disease Progression

All Science Journal Classification (ASJC) codes

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Acharya, S., Quesada, S., Coca, K., Richardson, C., Hoehn, M. E., Chiang, J., ... Merchant, T. E. (Accepted/In press). Long-term visual acuity outcomes after radiation therapy for sporadic optic pathway glioma. Journal of Neuro-Oncology. https://doi.org/10.1007/s11060-019-03264-2

Long-term visual acuity outcomes after radiation therapy for sporadic optic pathway glioma. / Acharya, Sahaja; Quesada, Sophia; Coca, Kenneth; Richardson, Cody; Hoehn, Mary E.; Chiang, Jason; Qaddoumi, Ibrahim; Boop, Frederick; Gajjar, Amar; Merchant, Thomas E.

In: Journal of Neuro-Oncology, 01.01.2019.

Research output: Contribution to journalArticle

Acharya, S, Quesada, S, Coca, K, Richardson, C, Hoehn, ME, Chiang, J, Qaddoumi, I, Boop, F, Gajjar, A & Merchant, TE 2019, 'Long-term visual acuity outcomes after radiation therapy for sporadic optic pathway glioma', Journal of Neuro-Oncology. https://doi.org/10.1007/s11060-019-03264-2
Acharya, Sahaja ; Quesada, Sophia ; Coca, Kenneth ; Richardson, Cody ; Hoehn, Mary E. ; Chiang, Jason ; Qaddoumi, Ibrahim ; Boop, Frederick ; Gajjar, Amar ; Merchant, Thomas E. / Long-term visual acuity outcomes after radiation therapy for sporadic optic pathway glioma. In: Journal of Neuro-Oncology. 2019.
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abstract = "Purpose: Children with sporadic optic pathway glioma (OPG) commonly experience a decline in visual acuity (VA). This study aimed to quantify long-term VA outcomes after definitive radiation therapy (RT). Methods: From 1997 to 2017, 41 patients underwent RT for OPG and had baseline VA testing. All patients underwent serial VA testing every 3–6 months during the first 5 years and annually thereafter. The cumulative incidence of VA decline or improvement (per eye) was estimated using death as a competing risk. Results: Mean follow-up was 5 years. Most tumors (93{\%}) involved the postchiasmatic optic tracts and/or hypothalamus. Of the tumors tested for BRAF alterations (n = 15), 67{\%} had a BRAF fusion. Median time to VA decline was 20 months in the eye with worse vision and 22 months in the better eye. For the worse eye, the 5-year cumulative incidences of VA decline and improvement were 17.9{\%} [95{\%} confidence interval (CI) 7–32.8{\%}] and 13.5{\%} (95{\%} CI 4.7–26.7{\%}), respectively. For the better eye, the 5-year cumulative incidences of VA decline and improvement were 11.5{\%} (95{\%} CI 3.5–30.7{\%}) and 10.6{\%} (95{\%} CI 2.6–25.2{\%}), respectively. Visual outcomes did not correlate with radiographic evidence of tumor progression. Conclusions: The 5-year cumulative incidence of VA decline was low. VA decline is most likely to occur within the first 2 years after RT and is not associated with radiographic progression of disease, highlighting the need for frequent ophthalmologic exams during this period.",
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T1 - Long-term visual acuity outcomes after radiation therapy for sporadic optic pathway glioma

AU - Acharya, Sahaja

AU - Quesada, Sophia

AU - Coca, Kenneth

AU - Richardson, Cody

AU - Hoehn, Mary E.

AU - Chiang, Jason

AU - Qaddoumi, Ibrahim

AU - Boop, Frederick

AU - Gajjar, Amar

AU - Merchant, Thomas E.

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N2 - Purpose: Children with sporadic optic pathway glioma (OPG) commonly experience a decline in visual acuity (VA). This study aimed to quantify long-term VA outcomes after definitive radiation therapy (RT). Methods: From 1997 to 2017, 41 patients underwent RT for OPG and had baseline VA testing. All patients underwent serial VA testing every 3–6 months during the first 5 years and annually thereafter. The cumulative incidence of VA decline or improvement (per eye) was estimated using death as a competing risk. Results: Mean follow-up was 5 years. Most tumors (93%) involved the postchiasmatic optic tracts and/or hypothalamus. Of the tumors tested for BRAF alterations (n = 15), 67% had a BRAF fusion. Median time to VA decline was 20 months in the eye with worse vision and 22 months in the better eye. For the worse eye, the 5-year cumulative incidences of VA decline and improvement were 17.9% [95% confidence interval (CI) 7–32.8%] and 13.5% (95% CI 4.7–26.7%), respectively. For the better eye, the 5-year cumulative incidences of VA decline and improvement were 11.5% (95% CI 3.5–30.7%) and 10.6% (95% CI 2.6–25.2%), respectively. Visual outcomes did not correlate with radiographic evidence of tumor progression. Conclusions: The 5-year cumulative incidence of VA decline was low. VA decline is most likely to occur within the first 2 years after RT and is not associated with radiographic progression of disease, highlighting the need for frequent ophthalmologic exams during this period.

AB - Purpose: Children with sporadic optic pathway glioma (OPG) commonly experience a decline in visual acuity (VA). This study aimed to quantify long-term VA outcomes after definitive radiation therapy (RT). Methods: From 1997 to 2017, 41 patients underwent RT for OPG and had baseline VA testing. All patients underwent serial VA testing every 3–6 months during the first 5 years and annually thereafter. The cumulative incidence of VA decline or improvement (per eye) was estimated using death as a competing risk. Results: Mean follow-up was 5 years. Most tumors (93%) involved the postchiasmatic optic tracts and/or hypothalamus. Of the tumors tested for BRAF alterations (n = 15), 67% had a BRAF fusion. Median time to VA decline was 20 months in the eye with worse vision and 22 months in the better eye. For the worse eye, the 5-year cumulative incidences of VA decline and improvement were 17.9% [95% confidence interval (CI) 7–32.8%] and 13.5% (95% CI 4.7–26.7%), respectively. For the better eye, the 5-year cumulative incidences of VA decline and improvement were 11.5% (95% CI 3.5–30.7%) and 10.6% (95% CI 2.6–25.2%), respectively. Visual outcomes did not correlate with radiographic evidence of tumor progression. Conclusions: The 5-year cumulative incidence of VA decline was low. VA decline is most likely to occur within the first 2 years after RT and is not associated with radiographic progression of disease, highlighting the need for frequent ophthalmologic exams during this period.

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