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  • Visual Impairment at Time of Childhood Brain Tumor Dx

    By Jean Shaw
    Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, October 2022

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    Nuijts et al. set out to assess the preva­lence and types of abnormal ophthal­mic findings in children with a newly diagnosed brain tumor. They found a high prevalence of visual impairment, even in those children who did not present with visual symptoms at the time of diagnosis.

    For this prospective cohort study, the researchers evaluated 170 young Dutch patients (median age, 8.3 years; range, .2 to 17.8 years) who were diag­nosed with a brain tumor between May 15, 2019, and Aug. 11, 2021. Infratento­rial tumors were diagnosed in 82 of the children, while 88 had supratentorial tumors.

    Overall, 101 of the children (59.4%) presented with visual symptoms at the time of diagnosis, most often diplopia (42 children), decreased vision (42), eye movement disorders (32), and visual field (VF) loss (23). In addition, 30 children initially presented to an oph­thalmologist, after which a brain tumor diagnosis was established.

    A complete ophthalmic examination was conducted at the time of diagnosis; this revealed abnormal ophthalmic findings in 134 of the patients (78.8%), notably papilledema (52.4%), gaze deficits (33.5%), VF defects (28.1%), nystagmus (24.8%), strabismus (19.9%), and decreased VA (8.6%). Of the 69 children who initially presented with­out visual symptoms, 24.4% had VF defects, and 9.8% had visual impair­ment in both eyes.

    The findings support the need for a standardized ophthalmologic exam at the time of diagnosis, regardless of presenting visual symptoms, the researchers said.

    The original article can be found here.