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Ophthalmic Outcomes in Children With Spina Bifida Myelomeningocele in Ireland
Insights
Ophthalmic complications are common in children with spina bifida myelomeningocele (SBM). Higher spinal lesions correlate with poorer visual acuity, and shunt status impacts papilledema and refractive errors.
Area of Science:
- Pediatric Ophthalmology
- Neuroscience
- Genetics and Developmental Biology
Background:
- Spina bifida myelomeningocele (SBM) is a complex congenital condition.
- Ophthalmic complications can significantly impact the quality of life for affected children.
Purpose of the Study:
- To investigate ophthalmic complications in Irish children with SBM.
- To evaluate the influence of spinal lesion level and shunt status on visual outcomes.
Main Methods:
- Retrospective audit of 129 children with SBM.
- Analysis of visual acuity, refractive errors, strabismus, papilledema, optic atrophy, and cortical visual impairment (CVI).
- Statistical analysis using chi-square and Kruskal-Wallis tests.
Main Results:
- 18.2% of children experienced visual impairment; 40.8% had significant refractive errors; 33.3% had strabismus.
- Higher spinal lesions were linked to worse visual acuity (P=.019).
- Ventriculoperitoneal shunts were associated with papilledema (P=.034) and refractive errors (P=.019).
Conclusions:
- Refractive errors, strabismus, and visual impairment are prevalent in SBM.
- Higher spinal lesions and shunt status are significant factors influencing visual outcomes in SBM.
- Early ophthalmic screening and management are crucial for children with SBM.
Purpose:
To investigate the ophthalmic complications associated with spina bifida myelomeningocele (SBM) in Irish children and to evaluate the impact of spinal lesion levels and shunt status on visual outcomes.
Methods:
A retrospective audit was conducted on 129 children with SBM, examining visual acuity, refractive errors, strabismus, papilledema, optic atrophy, and cortical visual impairment (CVI). The median age of participants was 6.9 years (interquartile range [IQR] = 7.07), comprising 69 females (53.5%) and 60 males (46.5%). Data were analyzed using chi-square and Kruskal-Wallis tests to assess associations between spinal lesion levels, shunt status, and visual outcomes.
Results:
The majority of lesions were lumbar (60.47%), followed by sacral (20.16%), thoracic (18.60%), and occipital (0.78%). Ventriculoperitoneal shunts were present in 67.44% of participants. Most children had good visual acuity, with visual impairment observed in 18.2%. Significant refractive errors were present in 40.8% of cases, whereas strabismus was observed in 33.3% of patients, predominantly esotropia. Papilledema, optic atrophy, and CVI were present in 12.4%, 5.4%, and 4.7% of participants. Higher spinal lesion levels were significantly associated with worse visual acuity (P =.019), whereas ventriculoperitoneal shunt status was significantly associated with papilledema (P = .034) and significant refractive errors (P = .019). No significant associations were found for strabismus, optic atrophy, or CVI.
Conclusions:
Ophthalmic complications such as refractive errors, strabismus, and visual impairment are common in children with SBM. The authors found that higher spinal lesions were associated with worse visual acuity. Shunt placement was also associated with a history of papilledema and higher rates of significant refractive error. [.
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