估计眼底视网膜神经纤维层（RNFL）厚度和黄斑节细胞层-内膜网层（GCL-IPL）厚度测量的诊断准确性，以区分新被诊断出脑瘤的儿童中是否存在异常的视觉功能（即异常的年龄基准视力和/或视野缺损）。这是荷兰四家医院进行的一个前瞻性纵向全国队列研究的横断面分析，其中包括儿科肿瘤的国家转诊中心。纳入了0-18岁年龄组，具有新被诊断出的脑瘤，可靠的视力和/或视野检查和光学相干断层扫描的患者。诊断准确性通过敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）进行评估。在这项研究中，共有115名患者参与（男性67人[58.3％]，中位年龄10.6岁[范围，0.2-17.8岁]），其中可靠的RNFL厚度和GCL-IPL厚度测量分别在92名患者（80.0％）和84名患者（73.0％）中进行了测量。在特异性分别为44.5％和82.9％的条件下，平均RNFL厚度和平均GCL-IPL厚度检测异常视觉功能的敏感度分别为74.5％和41.7％。平均RNFL厚度和平均GCL-IPL厚度的PPV和NPV分别为33.0％和82.6％，以及57.1％和82.2％。使用平均RNFL厚度可正确区分十名患者中的七名存在异常视觉功能，使用平均GCL-IPL厚度可正确区分十名患者中的四名存在异常视觉功能。相对较高的NPV意味着平均RNFL厚度和平均GCL-IPL厚度测量正常的患者具有相对高的正常视觉功能的确定性。 ©2023年作者。由John Wiley＆Sons Ltd代表Acta Ophthalmologica Scandinavica Foundation出版的Acta Ophthalmologica。

To estimate the diagnostic accuracy of circumpapillary retinal nerve fibre layer (RNFL) thickness and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness measurements to discriminate an abnormal visual function (i.e. abnormal age-based visual acuity and/or visual field defect) in children with a newly diagnosed brain tumour.This cross-sectional analysis of a prospective longitudinal nationwide cohort study was conducted at four hospitals in the Netherlands, including the national referral centre for paediatric oncology. Patients aged 0-18 years with a newly diagnosed brain tumour and reliable visual acuity and/or visual field examination and optical coherence tomography were included. Diagnostic accuracy was evaluated with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).Of 115 patients included in the study (67 [58.3%] male; median age 10.6 years [range, 0.2-17.8 years]), reliable RNFL thickness and GCL-IPL thickness measurements were available in 92 patients (80.0%) and 84 patients (73.0%), respectively. The sensitivity for detecting an abnormal visual function was 74.5% for average RNFL thickness and 41.7% for average GCL-IPL thickness at a specificity of 44.5% and 82.9%, respectively. The PPV and NPV were 33.0% and 82.6% for the average RNFL thickness and 57.1% and 82.2% for the average GCL-IPL thickness.An abnormal visual function was discriminated correctly by using the average RNFL thickness in seven out of ten patients and by using the average GCL-IPL thickness in four out of ten patients. The relatively high NPVs signified that patients with normal average RNFL thickness and average GCL-IPL thickness measurements had a relative high certainty of a normal visual function.© 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.