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[Eye findings in paediatric brain tumour - data basis for a follow-up proposal]
Insights
Ophthalmologic examinations are crucial for children with brain tumors, with tumor location being a key risk factor for visual disturbances. Regular eye exams and specific tests like Visual Evoked Potentials (VEP) are recommended throughout treatment and lifelong follow-up.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Neuro-oncology
Context:
- Children with brain tumors frequently experience visual system issues.
- There is a lack of established guidelines for ophthalmic follow-up in this patient group.
Purpose:
- To analyze risk factors for ophthalmological findings in pediatric brain tumor patients.
- To establish recommendations for ophthalmic follow-up protocols.
Summary:
- Retrospective analysis of 125 children with brain tumors identified tumor location as the primary risk factor for visual problems.
- Eye motility issues correlate with brainstem invasion, malignancy grade, and mass effects.
- Visual Evoked Potential (VEP) alterations are common across all brain tumor types.
Impact:
- Provides a framework for regular ophthalmologic screening in pediatric brain tumor survivors.
- Highlights the importance of early detection and management of visual impairments.
- Aims to improve long-term quality of life by addressing vision-related complications.
Background:
Morphologic alterations and functional disturbances of the visual system are frequently observed in children with brain tumours. At present we are not aware of published data giving recommendations for ophthalmic follow-up in these patients.
Patients:
A retrospective analysis of 125 children with a brain tumour was done to perform a risk analysis.
Method:
According to a sequential test strategy risk factors for various eye findings have been evaluated.
Results:
Tumour location is the major risk factor for ophthalmological findings. Eye motility pathology was mainly associated with tumour invasion of the brain stem, grade of malignancy, and mass effects and occurred mainly in those patients with the presence of visual system symptoms as the leading symptom at the time of diagnosis. VEP alterations were a frequent sign in any group of brain tumours.
Conclusions:
As a follow-up for children with brain tumour, we recommend to perform an ophthalmologic examination at the time of diagnosis, before and after any neurosurgery, radiotherapy and chemotherapy respectively. During chemotherapy controls should be performed every 3 months. After the end of treatment the patients should be seen by an ophthalmologist at least once a year lifelong. For some well defined risk populations, we recommend more frequent controls. Visual Evoked Potentials and perimetry ought to be performed in any child at diagnosis, and more often in defined risk patients.