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A comparison of visual function scores in hydrocephalic infants with and without lumbosacral myelomeningocoele
M T Shokunbi1, T O Odebode, A M Agbeja-Baiyeroju
1Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria. shkunbi@skannet.com.ng
Insights
Hydrocephalus in children with myelomeningocele does not worsen visual impairment. Ventricular size, not spinal dysraphism, is the primary factor affecting vision in these patients.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Developmental Biology
Background:
- Children with myelomeningocele often have cerebral malformations, increasing susceptibility to visual impairment.
- Hydrocephalus is a common complication in these children, impacting intellectual function and potentially causing visual impairment.
Purpose of the Study:
- To investigate if hydrocephalic patients with lumbar myelomeningocele (HLM) face a higher risk of visual impairment compared to hydrocephalic patients without this condition (H).
Main Methods:
- A prospective study assessed five visual function parameters in 20 HLM children.
- Visual function scores were compared to a control group of hydrocephalic children without spinal dysraphism, matched for age, sex, and ventricular size.
- Assessed parameters included pupillary size/reaction, optic atrophy, visual fixation, and tracking.
Main Results:
- The two groups (HLM and H) showed similar age and sex distributions.
- Lateral ventricle dimensions were comparable between the groups.
- Mean total visual function scores (TVFS) were statistically similar (24.25 vs. 24.20, P=0.90).
Conclusions:
- Associated spinal dysraphism in hydrocephalic infants with lumbar myelomeningocele does not appear to further diminish visual function.
- Ventricular dilatation is identified as the principal determinant of visual impairment in this population.
Purpose:
The cerebrum is frequently malformed in children with myelomeningocoele. This anomaly renders them potentially susceptible to cerebral visual impairment. In these patients, hydrocephalus is an important and frequent complicating lesion which compromises intellectual function and may also cause cerebral visual impairment. In this study, we determined whether hydrocephalic patients with lumbar myelomeningocoele (HLM) are at a greater risk of visual impairment than hydrocephalic patients without this lesion (H).
Methods:
In this prospective study, we assessed five parameters of visual function in 20 hydrocephalic children with lumbar myelomeningocoele and compared the total visual function scores (TVFS) obtained with those from hydrocephalic children without overt spinal dysraphism, but similar in age, sex and ventricular size. The parameters, which were assessed with the aid of a quantitative grading scale, were pupillary size and reaction, optic atrophy, visual fixation and tracking.
Results:
The age and sex distributions of the patients in the two groups were similar. The anterior and posterior dimensions of the lateral ventricles were also similar. The mean (SD) of the TVFS were 24.25 (3.63) and 24.20 (3.47) respectively for the two groups (P = 0.90).
Conclusions:
The results suggest that, in hydrocephalic infants with lumbar myelomeningocoele, visual function is not further diminished by the associated dysraphism and that ventricular dilatation is the major determinant of visual impairment.
