Children with newly diagnosed brain tumors often have ophthalmologic abnormalities

Investigators evaluated the prevalence and clinical presentation of ophthalmologic abnormalities in children with brain tumors.

Study design

This was a prospective, nationwide cohort study of 170 children (aged ≤18 years) in the Netherlands who were newly diagnosed with a brain tumor. Complete ophthalmologic examinations with additional orthoptic evaluation and visual field testing were performed in age-appropriate children.

Outcomes

Approximately 60% of children with newly diagnosed brain tumors presented with visual symptoms at diagnosis. About half of all patients presented with papilledema, particularly with supratentorial cerebral and infratentorial tumors. Other common ophthalmologic abnormalities included visual field deficits (most notably in patients with midline supratentorial tumors and nystagmus). In the group who did not present with visual symptoms, 65% were found to have ophthalmologic abnormalities on examination.

Limitations

Of the 263 eligible patients, only 170 were included; the exclusion of almost 100 patients may skew the data. Although examinations were performed within 4 weeks of diagnosis, there was variability in whether patients were examined prior to or after initiation of treatment (e.g., surgery).

Clinical significance

More than half of children with newly diagnosed brain tumors have visual complaints and ophthalmologic findings that can be vision-threatening. Ophthalmologic examination in these patients is important.