{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:48:19Z","timestamp":1792450099643,"version":"4.5.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optic pathway gliomas (OPG) in infants and young children (IYC) are associated with significant long-term morbidity, but visual outcomes in this high-risk group remain poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed clinical, ophthalmologic, and radiological data from 81 children diagnosed with OPG before age 3 and followed at a single institution between 1981 and 2020. Best-corrected visual acuity (BCVA) was assessed using age-adjusted criteria and REiNS recommendations. Survival outcomes and prognostic factors were analysed using Kaplan-Meier and regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-one children underwent initial surgery, four of whom had no further treatment. Sixty-six were treated with chemotherapy (62) or radiotherapy (4) at diagnosis, while 11 were initially observed. At presentation, 74% had abnormal-for-age BCVA, and 33% met criteria for bilateral visual impairment. After a median 11-year follow-up, 81.5% showed abnormal vision, 45.7% were visually impaired, and 26% were bilaterally blind. Only 36% showed BCVA improvement, while 32% worsened. The 10-year visual progression-free survival was 41.3%. Post-chiasmatic tumor involvement was the only independent predictor of visual progression (HR 2.91, P\u2009=\u2009.033). Most cases of visual deterioration occurred within the first 2 years, but late events up to 16 years post-diagnosis were also observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IYC with OPG suffer from substantial and often irreversible visual morbidity, frequently already present at diagnosis. Despite long-term survival, functional visual outcomes remain poor. Our findings underscore the urgent need for earlier, vision-directed interventions and long-term visual monitoring. This large single-center cohort provides a robust benchmark for future prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/nop\/npaf129","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T13:01:00Z","timestamp":1765976460000},"page":"608-619","source":"Crossref","is-referenced-by-count":1,"title":["Visual morbidity, long-term outcome and prognostic factors in infants and young children with optic pathway low-grade glioma"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5013-1138","authenticated-orcid":false,"given":"Stefania","family":"Picariello","sequence":"first","affiliation":[{"name":"Neuro-Oncology Unit, Department of Paediatric Oncology, Santobono-Pausilipon Children\u2019s Hospital , Naples,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronwen","family":"Walters","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, 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London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen Alexandra","family":"Spoudeas","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Great Ormond Street Hospital for Children , London,","place":["UK"]},{"name":"Section of Molecular Basis of Rare Disease, Genetics and Genomic Medicine Research and Teaching Department, University College London Great Ormond Street Hospital Institute of Child Health , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7015-5196","authenticated-orcid":false,"given":"Kristian","family":"Aquilina","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Great Ormond Street Hospital for Children , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Ching","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Oncology, University College 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