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Show Poster 230 Visual Sequelae in Children with Primary CNS Tumors Yin Allison Liu1, Timothy Winter2 1 Loma Linda University Children's Hospital, Loma Linda, California, USA, 2Loma Linda University Medical Center, Loma Linda, California, USA Introduction: The prevalence of visual sequelae in children with brain tumors has received limited attention in the literature. They are oftentimes unrecognized due to limited patient/caregiver report. As survival improves with emerging treatments, systematic neuroophthalmolgic evaluations may help improve long-term visual outcomes and quality-of-life. Methods: We reviewed outcomes of 142 children with primary brain tumors. Results: A total of 68 patients (Male=32, Female=36) and 222 ophthalmology evaluations were reviewed. The median age at diagnosis was 7 (0-18) years. Nine children (13%) presented with visual symptoms. Hydrocephalus was present in 65% of all patients. Tumor types mainly included glioma (35%), medulloblastoma (13%), and ependymoma (10%). Tumor locations were on the optic pathway (45%) and in the posterior fossa and brainstem (55%). Surgery was performed on 93% of patients. Gross total resection was achieved in 51% from initial surgery. A total of 54% received chemotherapy and/or radiation. Overall survival was 84% over a median follow-up of 28 months (1-180 months). Median time from tumor diagnosis to initial ophthalmological evaluation was 9 months (0-94 months). Initial complaints included abnormities in vision (35%), gaze (34%), none (22%), visual field (4.4%), and other (7.4%). Exam found 62% with visual acuity impairment, 51% with strabismus, 37% with amblyopia, 35% with papilledema, 19% with visual field defects, 17.6% with optic nerve atrophy with or without papilledema, 15% with exposure keratopathy (30% required tarsorrhaphy or corneal transplant). Discrepancy between the prevalence of patient/caregiver reported eye symptoms and abnormal ophthalmologic exam findings was significant (P=0.011). Noticeably, there were 74 patients with mainly low grade brain tumors were never evaluated by an ophthalmologist (overall survival = 86.5%). Conclusions: Both afferent and efferent visual sequelae are prominent in children with brain tumors, even when asymptomatic. A single ophthalmologic evaluation is suggested to evaluate for complications from tumor and/or treatment to prevent vision threatening disease. References: None. Keywords: Pediatric neuro-ophthalmology, Tumors, Visual fields, Optic neuropathy, Ocular Motility Financial Disclosures: The authors had no disclosures. Grant Support: None. 2018 Annual Meeting | 371 |
