Related Experiment Video
Updated: Oct 22, 2025
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Vision-related quality-of-life in pediatric primary brain tumor patients
Jason H Peragallo1,2, Beau B Bruce3,4,5, Caroline Vasseneix3
1Department of Ophthalmology, Emory University School of Medicine, 1365B Clifton Rd NE, Atlanta, GA, 30322, USA. jperaga@emory.edu.
Insights
Pediatric brain tumor survivors frequently experience vision loss and impaired vision-related quality-of-life (VR-QOL), even after treatment. Early neuro-ophthalmologic exams are crucial for timely interventions.
Area of Science:
- Neuro-oncology
- Ophthalmology
- Pediatric Oncology
Background:
- Childhood brain tumors are a leading cause of cancer-related death.
- Improved survival rates highlight the need to address long-term morbidities.
- Visual dysfunction and impaired vision-related quality-of-life (VR-QOL) are often overlooked in pediatric brain tumor patients.
Purpose of the Study:
- To investigate the prevalence and impact of visual impairment on VR-QOL in pediatric brain tumor patients.
- To assess the correlation between visual acuity, legal blindness, and VR-QOL.
- To evaluate health-related quality-of-life (HR-QOL) in this population.
Main Methods:
- A quality improvement project at a tertiary care center included 77 pediatric patients (≤18 years) >6 months post-diagnosis.
- Standardized neuro-ophthalmologic examinations were performed, excluding intrinsic anterior visual pathway tumors.
- Validated questionnaires (CVFQ, EYE-Q for VR-QOL; PedsQL Brain Tumor Module for HR-QOL) were administered to patients and parents.
Main Results:
- Craniopharyngiomas and astrocytomas were the most common diagnoses.
- 57% of patients had visual impairment, with 16% legally blind.
- Lower visual acuity and legal blindness significantly correlated with worse VR-QOL (Eye-Q scores) and cognitive HR-QOL.
Conclusions:
- Pediatric brain tumor patients often have severely affected vision and VR-QOL, irrespective of tumor cure status.
- Systematic neuro-ophthalmologic screening is essential for early detection and intervention.
- Prompt ophthalmologic care can mitigate long-term visual deficits and improve quality of life.
Purpose:
Brain tumors are the leading cause of death from childhood cancer. Although overall survival has improved due to earlier detection, better therapies, and improved surveillance, visual dysfunction and impaired vision-related quality-of-life (VR-QOL) are often unrecognized in children. This project investigated VR-QOL in pediatric brain tumor patients.
Methods:
We evaluated visual impairment and quality-of-life (QOL) in a quality improvement project at one tertiary care center. Patients ≤ 18, greater than 6 months from diagnosis of brain tumor, excluding intrinsic anterior visual pathway tumors, underwent standardized neuro-ophthalmologic examination. Health-related QOL (HR-QOL) (PedsQL Brain Tumor Module) and VR-QOL questionnaires [CVFQ (Children's Visual Function Questionnaire) in children < 8, and EYE-Q in children 8-18] were obtained from patients and parents.
Results:
Among 77 patients, craniopharyngiomas (n = 16, 21%) and astrocytomas (n = 15, 20%) were the most common tumors. Among 44/77 (57%) visually impaired children, 7 (16%) were legally blind. Eye-Q median score was 3.40 (interquartile range 3.00-3.75), worse than average scores for normal children. Eye-Q score decreased 0.12 with every 0.1 increase in logMAR visual acuity (p < 0.001). Patients who were legally blind had a significantly lower Eye-Q score than those who were not [0.70 vs. 3.44 (p < 0.001)]. Cognitive HR-QOL scores decreased 1.3 for every 0.1 increase in logMAR visual acuity (p = 0.02).
Conclusions:
Pediatric brain tumor patients' vision, HR-QOL, and VR-QOL were often severely affected even when tumors were considered cured. Visual acuity and legal blindness correlated with VR-QOL. Systematic neuro-ophthalmologic examinations in pediatric primary brain tumor patients are necessary to facilitate early preventative and corrective ophthalmologic interventions.
