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Published on: July 9, 2016
Visual impairment in children with acute nontraumatic coma
N G Ziakas1, C P Wong, A S Ramsay
1Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon-Tyne, United Kingdom.
Insights
Visual impairment affects 6.6% of children surviving acute nontraumatic coma, persisting at 12 months. This study determined the incidence and severity of vision loss in pediatric patients after coma.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Epidemiology
Background:
- Acute nontraumatic coma in children is a critical condition requiring comprehensive assessment.
- Understanding the long-term sequelae, particularly visual impairment, is crucial for patient management and rehabilitation.
Purpose of the Study:
- To ascertain the incidence and severity of visual impairment in pediatric patients following acute nontraumatic coma.
- To evaluate the persistence and progression of visual deficits over a 12-month period.
Main Methods:
- Prospective epidemiologic study conducted over 18 months in England.
- Inclusion criteria: children aged 1 month to 16 years with Glasgow Coma Score ≤12 for >6 hours or death within 6 hours of consciousness decrease.
- Ophthalmologic assessments at 6 weeks and 12 months for survivors.
Main Results:
- 287 children were studied; 127 died.
- Visual impairment was confirmed in 10 of 137 survivors at 6 weeks.
- At 12 months, 9 children had persistent visual impairment, and 1 showed improvement.
Conclusions:
- 6.6% of pediatric survivors of acute nontraumatic coma experienced persistent visual impairment at 12 months.
- The incidence of visual impairment in this population is estimated at 0.97 per 100,000 children annually.
Purpose:
To determine the incidence and severity of visual impairment in children following acute nontraumatic coma.
Methods:
An 18-month prospective epidemiologic study of acute nontraumatic coma was undertaken in the former Northern NHS Region of England. Children aged >1 month and <16 years were included in the study if they had a Glasgow Coma Score of < or = 12 for >6 hours or if they died within 6 hours of the onset of decreased levels of consciousness. For survivors, ophthalmologic assessments were performed 6 weeks and 12 months after presentation.
Results:
Two hundred eighty-seven children were included in the study, of whom 127 died. Of the 137 examined survivors, 35 had visual abnormalities suspected by the examining neurologist during the ophthalmic assessment. Of these, visual impairment was confirmed in 10 children at the 6-week assessment by the pediatric ophthalmologist. At the 1 2-month assessment, visual impairment remained stable in 9 children and improved in 1.
Conclusion:
In this study, 6.6% of children surviving acute nontraumatic coma had visual impairment that persisted at the 12-month follow-up examination. Incidence of visual impairment in acute nontraumatic coma is 0.97 per 100,000 children per year.
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