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Abnormal optic disc and retinal vessels in children with surgically treated hydrocephalus
1Department of Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital/Ostra, 416 85 Göteborg, Sweden. susann.andersson@oft.gu.se
Insights
Children with surgically treated hydrocephalus show smaller optic discs and abnormal retinal vessels, suggesting developmental disturbances. Improved care may be reducing optic atrophy rates.
Area of Science:
- Ophthalmology
- Pediatric Neurology
- Developmental Biology
Background:
- Hydrocephalus can impact neurological development.
- Optic nerve and retinal vasculature are sensitive indicators of intracranial pressure and developmental changes.
Purpose of the Study:
- To examine optic disc and retinal vessel morphology in children with surgically treated hydrocephalus.
- To identify potential developmental disturbances related to hydrocephalus.
Main Methods:
- Prospective, population-based study of 69 children with early surgically treated hydrocephalus.
- Ophthalmoscopy and digital image analysis of fundus photographs for optic disc and retinal vessel morphology.
- Comparison with a reference group.
Main Results:
- 14% of children with hydrocephalus exhibited optic atrophy.
- Significantly smaller optic disc and rim areas in hydrocephalic children compared to controls.
- Abnormal retinal vascular patterns, including straighter arteries and fewer branching points, were observed.
Conclusions:
- Hydrocephalus is linked to reduced optic disc/rim areas and abnormal vascular patterns, indicating pre/perinatal developmental issues.
- Lower optic atrophy rates suggest improved perinatal care and intracranial pressure management.
- Findings highlight the importance of monitoring ocular structures in hydrocephalic children.
Aims:
To investigate the morphology of the optic disc and retinal vessels in children with surgically treated hydrocephalus.
Methods:
A prospective, population-based study was performed in 69 children (median age 9.6 years) with early surgically treated hydrocephalus. All children were examined by ophthalmoscopy. Additionally, optic disc and retinal vessel morphology was evaluated in 55 children by digital image analysis of ocular fundus photographs.
Results:
Optic atrophy was found in 10 of 69 children (14%). In comparison with a reference group, the median optic-disc area was significantly smaller (p = 0.013) in the children with hydrocephalus. There was no corresponding difference in cup area, so the rim area was significantly smaller in the hydrocephalic children (p = 0.002). Children with hydrocephalus had an abnormal retinal vascular pattern, with significantly straighter retinal arteries and fewer central vessel branching points compared with controls (p<0.001 and p<0.001, respectively).
Conclusion:
Hydrocephalus is associated with subnormal optic disc and rim areas and an abnormal vascular pattern, indicating a pre/perinatal disturbance of the development of these structures. A promising finding is that the frequency of optic atrophy in the present study was lower than previously reported, most likely reflecting improved perinatal care and better regulation of the intracranial pressure.
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