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Sabrina Jisun Myung Cho, Carolina Pelegrini Gracitelli, Danilo A. Paulo, Luciana da Cruz Noia; Prevalence of Ocular Findings in Patients with Central Nervous System Tumor in a Tertiary Hospital. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5607.
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© ARVO (1962-2015); The Authors (2016-present)
The main cause of mortality from neoplasm in children is the central nervous system (CNS) tumor, for this reason, there is an increasing effort to provide data to earlier detection and treatment of this disease. The purpose of this study was to describe the prevalence of ocular findings in children with CNS tumors that were followed up in a Center of Pediatric Oncology in São Paulo, Brazil.
An observational study was carried out. Information of demographic and ocular data were collected between Sep 2016 and Sep 2017 from the hospital medical records from pediatric patients aged from 0 to 19 years, with CNS tumor that were being followed up in a tertiary hospital, and were systematically referred to the Neurophthalmology outpatient clinic for evaluation, despite presence of visual symptoms or findings.
A total of 230 eyes of 115 patients were included. The mean age of all participants was 10.08±4.85 years (range 1-19 years). 51.9% of all participants were male. Out of the 104 patients that reported visual acuity (VA), 51 (49%) had reduced VA. The mean best-corrected visual acuity (BCVA) was 0.28±0.38 logMAR (range 0-1 logMAR). 33.2% of all participants presented alteration of extrinsic ocular motility (EOM). No participant had exophthalmia and only 8 (8.5%) had papillary edema. 21 patients (21%) had optic atrophy and 3 (2.9%) of them did not present any CNS tumor. Based on the diagnosis, most of them were gliomas (55.6%), followed by craniopharyngiomas (15.1%), germ cell tumors (11.3%), and both ganglioglioma (1.9%) and leukemia (1.9%). Mean age in patients with glioma was 9.4±4.68 years (range 1-18 years), with no sex preference and mean BCVA of 0.27 ± 0.34 LogMAR. 18.6% had neurofibromatosis and optic nerve glioma. Mean age in patients with craniopharyngioma was 12.62±4.16 years (range 7-19 years), 62.5% were male, and the mean BCVA was of 0.35±0.42 LogMAR. In patients with germ cell tumor, the mean age was 11.75±3.93 years (range 2-19 years), 58.3% were male and the mean BCVA was of 0.25±0.44 LogMAR.
The most prevalent diagnosis were glioma and craniopharyngioma. Patients with craniopharyngioma were older, with male preference and worse VA than those with glioma or germ cell tumor. Almost one fifth of the patients with glioma had neurofibromatosis. We reinforce the importance a complete ocular exam in children with CNS tumor suspicion even without any symptoms.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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