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Visual function and compensatory mechanisms for hemianopia after hemispherectomy in children.
Yvonne Koenraads1, Denise C P van der Linden, Monique M J van Schooneveld
1Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands.
Children undergoing hemispherectomy often develop good visual outcomes despite homonymous hemianopia (HH). They frequently adopt anomalous head posture (AHP) and exotropia (XT) as compensatory mechanisms (CMs) to improve visual field function.
Area of Science:
- Pediatric Ophthalmology
- Neuroscience
- Neurosurgery
Background:
- Hemispherectomy in children can lead to visual impairments like homonymous hemianopia (HH).
- Anomalous head posture (AHP) and exotropia (XT) have been observed as potential compensatory mechanisms (CMs) in these patients.
Purpose of the Study:
- To assess the functional visual outcomes in children post-hemispherectomy.
- To determine the prevalence of compensatory mechanisms (CMs) such as AHP and XT.
Main Methods:
- Retrospective review of patient files from hemispherectomized children with ophthalmologic examinations.
- Collection of preoperative and postoperative data on visual function, head posture, ocular alignment, and cognitive development.
Main Results:
- Most children (87%) achieved normal or mild visual acuity post-surgery.
- Homonymous hemianopia (HH) was present in all assessed children.
- AHP (53%) and XT (38%) were common, contralateral to the hemispherectomy side.
Conclusions:
- The majority of children have good visual outcomes after hemispherectomy, despite HH.
- AHP and XT frequently develop as adaptive strategies to optimize visual field function.
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