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Pediatric homonymous hemianopia.
Sachin Kedar1, Xiaojun Zhang, Michael J Lynn
1Department of Ophthalmology, Emory University, Atlanta, GA 30322, USA.
Summary
Pediatric homonymous hemianopia, often caused by trauma or tumors, shows spontaneous improvement in about one-third of cases. Early recognition is crucial, as diagnosis is frequently delayed in children.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Homonymous hemianopia is a visual field defect resulting from retrochiasmal pathway lesions.
- Little is known about its occurrence and characteristics in the pediatric population.
Purpose of the Study:
- To compare the causes, characteristics, and outcomes of homonymous hemianopia in pediatric versus adult patients.
- To highlight the differences in etiology and lesion location between the two groups.
Main Methods:
- Retrospective analysis of 852 patients with homonymous hemianopia (1989-2004).
- Comparison of demographic, clinical, and visual field data between pediatric (≤18 years) and adult (>18 years) groups.
- Analysis of causative lesions, their locations, and visual field defect evolution.
Main Results:
- 81 children and 771 adults were identified with homonymous hemianopia.
- Traumatic brain injury and tumors were the leading causes in children, while infarction predominated in adults.
- Lesions involved optic radiations and occipital lobes in both groups, with differing frequencies.
- Approximately one-third of pediatric cases showed spontaneous improvement, with 50% improvement within one month of onset in a subset.
Conclusions:
- Trauma and tumors are the primary causes of homonymous hemianopia in children.
- Spontaneous visual field improvement occurs in about one-third to one-half of pediatric cases within months.
- Delayed recognition of homonymous hemianopia is common in children.