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New-Onset Vision Impairment in Children: Magnetic Resonance Imaging Findings by Age Groups
Esra Çıvgın1, Semra Duran1, Izzet Selçuk Parlak1
1Department of Radiology, Ankara Bilkent City Hospital, Ankara, Türkiye.
Insights
Pediatric vision impairment causes vary by age. Tumors are common in preschoolers, idiopathic intracranial hypertension in schoolchildren, and demyelinating disorders in adolescents, highlighting MRI
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Ophthalmology
Background:
- Non-traumatic visual impairment in children, though rare, requires prompt diagnosis to prevent neurocognitive deficits.
- Magnetic resonance imaging (MRI) is a key tool for identifying underlying causes of vision loss in pediatric patients.
Purpose of the Study:
- To identify the most common causes of non-traumatic visual impairment in pediatric patients.
- To analyze these causes based on distinct age groups: preschoolers, schoolchildren, and adolescents.
- To correlate findings with magnetic resonance imaging (MRI) results.
Main Methods:
- Retrospective review of contrast-enhanced cranial and orbital MRI scans from pediatric patients with new-onset visual impairment (June 2019 - June 2022).
- Categorization of MRI findings into tumors, idiopathic intracranial hypertension, demyelinating disorders, infections, isolated optic neuritis, and others.
- Stratification of patients into age groups (preschoolers, schoolchildren, adolescents) for comparative analysis.
Main Results:
- Pathologic MRI findings were present in 117 of 238 patients.
- Overall common pathologies included tumors (26.4%), idiopathic intracranial hypertension (24.7%), and demyelinating disorders (18.8%).
- Age-specific findings: tumors in preschoolers (69.2%), idiopathic intracranial hypertension in schoolchildren (36.3%), and demyelinating disorders in adolescents (32.7%).
Conclusions:
- Acute vision impairment in children can indicate serious underlying pathologies.
- MRI is crucial for diagnosing vision impairment in children, especially when examinations are challenging.
- Cranial and orbital MRI aids in detecting potentially life-threatening conditions in pediatric vision impairment.
Introduction:
Non-traumatic visual impairment is rare in the pediatric population, but early diagnosis and treatment of the cause is crucial to prevent long-term consequences affecting children's neurocognitive development. The authors aim to determine the most common causes of non-traumatic visual impairment in pediatric patients according to age groups by magnetic resonance imaging (MRI).
Methods:
Images of patients who underwent contrast-enhanced cranial and orbital MRI for new-onset visual impairment between June 2019 and June 2022 were retrospectively reviewed. MRI findings were categorized as tumors, idiopathic intracranial hypertension, demyelinating disorders, infections, isolated optic neuritis, and others. The patients were grouped according to age as preschoolers, schoolchildren, and adolescents. Demographic features of patients and MRI findings were collected and compared among age groups.
Results:
One hundred seventeen of the 238 patients had pathologic MRI findings. The most common pathologies were tumors (26.4%), idiopathic intracranial hypertension (24.7%), demyelinating disorders (18.8%), infections (11.1%), and isolated optic neuritis (7.6%). Tumors (69.2%) in preschool children, idiopathic intracranial hypertension (36.3%) in schoolchildren, and demyelinating disorders (32.7%) in adolescents were the most common cause of vision impairment by age group.
Conclusion:
Children with acute vision impairment could have severe pathologies. Tumors in preschool children, idiopathic intracranial hypertension in schoolchildren, and demyelinating disorders in adolescents were the most common causes of new-onset vision impairment detected with MRI. Because of the difficulty of performing optimal ophthalmologic and neurologic examinations, especially in young children, cranial and orbital MRI should be considered to detect life-threatening pathologies.
