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Long-term ophthalmological follow-up of children with Parinaud syndrome
Nitza Goldenberg-Cohen1, Jordana Haber, Yonina Ron
1Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
Insights
Children with tumor-related Parinaud syndrome often experience lasting vision issues, including gaze limitations and abnormal eye movements, despite treatment. Long-term ophthalmological outcomes reveal subtle but measurable deficits years post-diagnosis.
Area of Science:
- Ophthalmology
- Pediatric Neurology
- Neuro-oncology
Background:
- Parinaud syndrome, often linked to tumors, affects eye movement control.
- Papilledema is a common sign of increased intracranial pressure in these cases.
Purpose of the Study:
- To evaluate the long-term ophthalmological outcomes in children diagnosed with Parinaud syndrome.
- To identify residual visual and ocular motor deficits following treatment.
Main Methods:
- Retrospective review of 6 pediatric patients with tumor-related Parinaud syndrome (2000-2007).
- Analysis of ophthalmological findings at diagnosis and long-term follow-up (mean 4.2 years).
- Assessment of visual acuity, ocular motility, and pupillary responses.
Main Results:
- Visual acuity remained stable or improved in most eyes; one patient showed significant improvement.
- Long-term follow-up revealed persistent up-gaze limitation, abnormal convergence, and convergence retraction nystagmus.
- One child developed bilateral optic atrophy, indicating potential permanent visual pathway damage.
Conclusions:
- Tumor-related Parinaud syndrome in children can lead to subtle yet persistent ophthalmological sequelae.
- Ocular motor abnormalities and visual field defects may remain years after treatment.
- Regular, long-term ophthalmological monitoring is crucial for these patients.
Background And Objective:
To assess the long-term ophthalmological outcome of Parinaud syndrome.
Patients And Methods:
The files of 6 children with tumor-related Parinaud syndrome diagnosed and observed from 2000 to 2007 were reviewed. All had papilledema indicating increased intracranial pressure.
Results:
Mean presentation-to-diagnosis delay was 3.6 weeks. Treatment consisted of surgical shunting and complete or partial resection with adjuvant chemotherapy (n = 4) and radiation (n = 3). Visual acuity remained stable or improved in 8 of 9 eyes with 20/30 visual acuity at diagnosis; improved bilaterally in 1 patient from 20/100 to 20/25; and deteriorated bilaterally in 1 patient from 20/30 and 20/200 to counting fingers and hand motions, respectively. The most improvement was achieved within 4 months. Findings at follow-up (mean: 4.2 years) included up gaze limitation (minimal in 2 patients), abnormal convergence, convergence retraction nystagmus, and light-near dissociation. One child had bilateral optic atrophy.
Conclusion:
Children with tumor-related Parinaud syndrome tend to have subtle but measurable residual ophthalmological findings years after diagnosis and treatment.
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