We read with great interest the article by Avery and associates published in the March 2011 issue of the journal. Their well-done prospective optical coherence tomography (OCT) study demonstrated that a decrease in retinal nerve fiber layer (RNFL) thickness was associated with decreased visual acuity in children with optic pathway gliomas (OPGs). We would like to draw your attention to our pilot study on the same subject, published in the December 2010 issue of the Journal of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) and accompanied by an editorial. Our research was also presented at the annual AAPOS meeting in April 2010. The goal of our study was to examine the utility of OCT in the evaluation of neurofibromatosis type 1 (NF-1) subjects with and without OPGs. We used OCT to detect RNFL changes attributable to OPGs in a cohort of pediatric patients with NF-1. A total of 15 NF-1 patients were prospectively enrolled from the multidisciplinary Duke Neurofibromatosis Clinic between December 2008 and December 2009. The final analysis consisted of 9 NF-1 subjects with OPG, 6 NF-1 subjects without OPG, and 15 age- and race-matched control subjects. We found NF-1 subjects with OPGs had thinner RNFL and maculae compared with control subjects, whereas NF-1 subjects without OPGs had an RNFL and macular thickness equivalent to healthy control subjects (see Table in our article published in J AAPOS ).
| NF-1 Subjects With Optic Pathway Gliomas | Matched Controls | NF-1 Subjects Without Optic Pathway Gliomas | Matched Controls | |
|---|---|---|---|---|
| Retinal nerve fiber layer thickness (μm) | 61.1 | 107.8 | 97.9 | 111.9 |
| SD | 13.5 | 10.3 | 9.5 | 10.9 |
| P < .0001 | Equivalent assuming a clinically significant difference of 10 μm | |||
| Macular volume (mm 3 ) | 6.20 | 6.81 | 6.93 | 7.00 |
| SD | 0.50 | 0.36 | 0.44 | 0.37 |
| P = .009 | Equivalent assuming a clinically significant difference of 0.3 mm 3 | |||
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