[Eye findings in paediatric brain tumour - data basis for a follow-up proposal].

BACKGROUND

Morphologic alterations and functional disturbances of the visual system are frequently observed in children with brain tumours. At present we are not aware of published data giving recommendations for ophthalmic follow-up in these patients.

PATIENTS

A retrospective analysis of 125 children with a brain tumour was done to perform a risk analysis.

METHOD

According to a sequential test strategy risk factors for various eye findings have been evaluated.

RESULTS

Tumour location is the major risk factor for ophthalmological findings. Eye motility pathology was mainly associated with tumour invasion of the brain stem, grade of malignancy, and mass effects and occurred mainly in those patients with the presence of visual system symptoms as the leading symptom at the time of diagnosis. VEP alterations were a frequent sign in any group of brain tumours.

CONCLUSIONS

As a follow-up for children with brain tumour, we recommend to perform an ophthalmologic examination at the time of diagnosis, before and after any neurosurgery, radiotherapy and chemotherapy respectively. During chemotherapy controls should be performed every 3 months. After the end of treatment the patients should be seen by an ophthalmologist at least once a year lifelong. For some well defined risk populations, we recommend more frequent controls. Visual Evoked Potentials and perimetry ought to be performed in any child at diagnosis, and more often in defined risk patients.