From the Guidelines
Research gaps in pediatric neuro-ophthalmology include limited understanding of disease progression, treatment efficacy, and long-term outcomes in children with visual pathway disorders, such as amblyopia, where socioeconomic factors and disparities in outcomes contribute to reduced success of therapy in certain populations 1. Some of the key questions that highlight these gaps include:
- How do socioeconomic factors, such as access to healthcare and insurance coverage, influence the detection and treatment of amblyopia in children, and what are the long-term implications for vision improvement 1?
- What are the optimal treatment protocols for pediatric amblyopia, including the role of optical correction, and how do they impact long-term visual outcomes and quality of life?
- How do genetic factors influence the development and progression of pediatric optic neuropathies, and what are the implications for treatment and management?
- What are the neurodevelopmental impacts of optic nerve hypoplasia beyond vision, and how do they affect the quality of life and morbidity in children?
- How effective are various treatments for pediatric myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) in preventing vision loss, and what are the potential long-term consequences of delayed or inadequate treatment?
- What are the most sensitive biomarkers for early detection of pediatric optic neuritis, and how can they be used to improve treatment outcomes and reduce morbidity? These questions reflect the need for more pediatric-specific research, as many current treatment approaches are extrapolated from adult studies without sufficient evidence for their efficacy in developing visual systems, highlighting the importance of prioritizing morbidity, mortality, and quality of life in the management of pediatric neuro-ophthalmologic conditions 1.
From the Research
Research Gaps in Pediatric Neurophthalmology
Some of the research gaps in pediatric neurophthalmology can be identified as follows:
- What are the long-term effects of optic neuritis on the visual acuity of pediatric patients, and how do these effects vary depending on the age of onset and the presence of underlying conditions such as multiple sclerosis 2, 3, 4?
- How do diagnostic and treatment approaches for pediatric optic neuritis differ from those for adults, and what are the implications of these differences for patient outcomes 2, 5, 6?
- What is the role of puberty in modifying the presentation and risk associations of pediatric optic neuritis, and how can this knowledge be used to inform diagnosis and treatment 5?
- How can prospective studies be designed and conducted to better understand the diagnosis, treatment, and prognosis of pediatric optic neuritis, given the rarity of the disease and the challenges of recruiting participants 2, 3?
- What are the most effective strategies for counseling families about the diagnosis, treatment, and prognosis of pediatric optic neuritis, and how can these strategies be tailored to meet the needs of individual patients and families 3?