Using bupivacaine to the medical rectus in addition to lateral rectus recession for convergence insufficiency type intermittent exotropia
Reviewed by Lauren Hepworth

This is a retrospective study of 60 paediatric optic pathway glioma (OPG) patients (NF1 or sporadic) presenting to Great Ormond Street between 2003-2017. Median follow-up was 82 months. Analysis was divided into best and worst eye vision representing level quality of life and maximal morbidity caused by the OPG respectively. Vision was classified using the PEDIG category (good <=0.2, moderate 0.3-0.6 and poor >=0.7 logMAR). At follow-up 75% (NF1) and 50% (sporadic) had good visual acuity in the better eye. 34% (NF1) and 54% (sporadic) children had poor visual acuity in the worse eye. Mean retinal nerve fibre layer thickness predicted good visual acuity for the better eye (OR 0.799 p =0.038). Poor eye visual acuity was best predicted with visual symptoms (OR 0.22, p=0.017) and poorer visual evoked potential (VEP) scores (OR=2.35, p =0.027). Sixteen children had homonymous hemianopias at follow-up predicted by poor binocular VEP score at presentation. Limitations of the paper include its retrospective nature, developmental limitations of children in testing and its design was never intended to evaluate different chemotherapy regimen effects on vision.

Visual outcomes and predictors in optic pathway glioma: a single centre study.
Bowman R, Walters B, Smith V, et al.
EYE
2023;37(6):1178-83.