Optic pathway glioma (OPG) is a childhood tumour of the visual pathway. Clinical management of OPG remains challenging, as the extent of tumour infiltration of the visual pathway is not perceptible on conventional MRI. We used diffusion-MRI to delineate the visual pathway in OPG patients. Advanced ophthalmological assessment was also performed using visual evoked potentials (VEP) and optical coherence tomography. We demonstrate that fractional anisotropy (FA) in the optic pathway correlates with retinal nerve-fibre layer thickness and VEP response, and tumour invasion anterior to the optic chiasm can be detected via inter-ocular differences in optic nerve FA.
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