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M. E. Hoehn, E. M. Bratton, B. Morris, N. C. Kerr; Visual and Systemic Outcomes in Children With Ophthalmic Findings in Neuroblastoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5272.
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To determine the visual and systemic outcomes of children with ophthalmologic involvement at diagnosis of neuroblastoma and/or during the course of the disease.
A retrospective chart review at St. Jude Children’s Hospital identified 336 patients diagnosed with neuroblastoma from 1995 until present.
Seventy patients had ophthalmic findings upon presentation and/or during the course of their disease (20.8%). Seven children had Horner syndrome (HS) at diagnosis and 12 patients developed post-operative HS. It persisted in all but one patient (5.3%) at the last exam. Seven patients had Opsoclonus-myoclonus-ataxia syndrome (OMA) at presentation. Only two of these twenty-six patients (7.7%) died of their disease. No visual loss was found in these children.Fifty-two patients had orbital metastases (either clinical or sub-clinical) at presentation and/or during recurrence of disease. Thirty-seven (71.2%) had proptosis/ecchymosis at diagnosis and/or recurrence. Thirty-one of the 52 (59.6%) patients died. Twenty-six of the 52 patients had recorded visual acuities; sixteen were 20/20-20/50, two were 20/60 to 20/100, three were between 20/200 and LP, and five patients had NLP vision.
Twenty percent of our patients with neuroblastoma developed ocular complications at some point in their disease. While HS and OMA were not associated with high mortality rates (7.7%) or ocular morbidity (0%), children with orbital metastases had higher rates of mortality (59.6%) and ocular morbidity (37%).HS and OMA in neuroblastoma are worrisome, but are not harbingers of a poor visual or systemic prognosis. However, orbital metastasis from neuroblastoma in our population was associated with significant morbidity and visual loss.
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