Visual Complications of Pediatric Posterior Fossa Tumors: Analysis of Outcomes

Nisha Gadgil, Jane Edmond, Katie Stormes, Sandi Lam, Veeral Shah

Research output: Contribution to journalArticle

Abstract

Objective: Visual abnormalities are common among children with posterior fossa tumors, resulting from disruption of ocular afferent and efferent systems due to the tumor or surgery. This study describes the visual complications and outcomes associated with these tumors. Methods: Clinical and radiographic data of patients who underwent index surgery for resection of posterior fossa tumor from 2007 to 2016 were reviewed. Descriptive statistics, univariate, and multivariate regression were performed to assess factors contributing to visual acuity and postoperative strabismus. Results: There were 182 patients who underwent posterior fossa craniotomy for neoplasm were included. Ophthalmologic symptoms were the fourth most common presenting complaint; initial ophthalmologic examination was abnormal in 40% of patients. Evaluation of visual acuity demonstrated a good outcome in 88% of patients following treatment. The most common postoperative oculomotor finding was esotropia (29%) which resolved spontaneously in more than half of patients. A good outcome was obtained in all patients who underwent surgery for esotropia. Hypertropia was noted in 14% of the cohort and less than half resolved spontaneously; less than half undergoing strabismus surgery for hypertropia had a good outcome. Multivariate analysis confirmed the association between cerebellar mutism and postoperative esotropia and hypertropia. Clinically significant pathological nystagmus was seen in 8% of the cohort. Conclusions: Our results indicate a good visual outcome in the majority of pediatric patients undergoing resection of posterior fossa tumors. Ophthalmologic complications should be appropriately evaluated and addressed to allow for the best possible vision to survivors of posterior fossa tumors.

Original languageEnglish (US)
Pages (from-to)48-54
Number of pages7
JournalPediatric neurology
Volume92
DOIs
StatePublished - Mar 1 2019

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Infratentorial Neoplasms
Strabismus
Pediatrics
Esotropia
Visual Acuity
Mutism
Craniotomy
Survivors
Neoplasms
Multivariate Analysis

Keywords

  • Posterior fossa tumor
  • Strabismus
  • Visional cerebellar mutism

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

Visual Complications of Pediatric Posterior Fossa Tumors : Analysis of Outcomes. / Gadgil, Nisha; Edmond, Jane; Stormes, Katie; Lam, Sandi; Shah, Veeral.

In: Pediatric neurology, Vol. 92, 01.03.2019, p. 48-54.

Research output: Contribution to journalArticle

Gadgil, Nisha ; Edmond, Jane ; Stormes, Katie ; Lam, Sandi ; Shah, Veeral. / Visual Complications of Pediatric Posterior Fossa Tumors : Analysis of Outcomes. In: Pediatric neurology. 2019 ; Vol. 92. pp. 48-54.
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