Reduced Vision in Children With Brain Tumours in Denmark-Prevalence, Severity, and Diagnostic Importance

To investigate the prevalence, severity and diagnostic value of reduced visual acuity (VA) in children with primary brain tumours.

All children (< 18 years) diagnosed with a primary brain tumour in Denmark during 2007-2017 were included in this nationwide retrospective study. The children were identified through the Danish Childhood Cancer Registry. Patient records from hospitals and private ophthalmologists were reviewed.

Reduced VA was observed in 18.8% (n = 87/464) of children with primary brain tumours and was the initial tumour sign in 12.6% (n = 11/87) of these cases. The median total diagnostic interval (TDI) for children whose initial tumour manifestation was reduced VA was 206 days (range: 46-718), whereas for those whose initial tumour sign was any other sign, the TDI was 86 days (range: 0-3000). Among children with reduced VA, 39.4% of those aged ≤ 6 years and 20.4% of those aged > 6 years had monocular vision impairment in their best-seeing eye. Optic disc abnormality (59.8%) was the most common accompanying ophthalmic tumour sign.

Reduced VA was frequent in children with brain tumours and typically occurred alongside other tumour signs. Timely diagnosis relies on close collaboration between paediatricians and ophthalmologists to identify additional tumour signs and determine the need for prompt neuroimaging.