Abnormal ophthalmological findings common in newly diagnosed brain tumor

There is a high prevalence of abnormal ophthalmological findings in children with a newly diagnosed brain tumor even when no visual symptoms are present, according to an article in JAMA Ophthalmology.

This prospective cohort study analyzed data from 170 children with a newly diagnosed brain tumor including 82 (48.2%) infratentorial tumors; 53 (31.2%) supratentorial midline tumors; and 35 (20.6%) cerebral hemisphere tumors.

Most patients (94.7%) had an orthoptic evaluation preoperatively (41.6%) or postoperatively (58.4%); 89.4% had visual acuity testing done preoperatively (41.4%) or postoperatively (58.6%); 71.2% had visual field examination done preoperatively (40.4%) or postoperatively (59.6%); and 96.5% had ophthalmoscopy preoperatively (50.0%) or postoperatively (50.0%).

At diagnosis, 101 patients (59.4%) had visual symptoms. During ophthalmological examination, 134 patients (78.8%) had abnormal findings, including papilledema in 86 of 164 patients who underwent ophthalmoscopy, gaze deficits in 54 of 161 who underwent orthoptic evaluation, visual field defects in 32 of 114 with reliable visual field examination, nystagmus in 40 and strabismus in 32 of 161 who underwent orthoptic evaluation, and decreased visual acuity in 13 of 152 with reliable visual acuity testing.

Overall, 65.2% of patients that did not have visual symptoms at diagnosis had ophthalmological abnormalities on examination.

Reference
Nuijts MA, Stegeman I, van Seeters T, et al. Ophthalmological Findings in Youths With a Newly Diagnosed Brain Tumor. JAMA Ophthalmol. Published online September 15, 2022. doi:10.1001/jamaophthalmol.2022.3628