Mole G, Edminson R, Higham A, Hopper C, Hildebrand D
Department of Paediatric Ophthalmology, Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK.
Department of Postgraduate Medical Education, Brighton & Sussex Medical School, Brighton, UK.
Neuroophthalmology. 2019 May 3;43(6):375-381. doi: 10.1080/01658107.2019.1597130. eCollection 2019 Dec.
This study looked at a single paediatric neuro-oncology centre's experience of childhood intracranial tumours seen in the ophthalmology clinic over an approximately five-year period. This was used to analyse the role of the ophthalmologist in their long term follow up.
A database was compiled of all children discussed at the neuro-oncology multi-disciplinary team (MDT) meeting between January 2012 and April 2017. All children who had an intracranial tumour determined by histology or suspected on neuro-imaging, who had also been seen in the ophthalmology clinic, were included. A retrospective case review was performed to create a record for each child.
The database contained 129 children of which 82 (64%) were boys and 47 (36%) were girls. Of these 89 (69%) had a histological diagnosis and 40 (31%) had a tumour suspected on neuroimaging. The most common tumour locations were the posterior fossa (n = 54, 42%), diencephalon (n = 20, 16%) and the visual pathways (n = 17, 13%). Papilloedema at first presentation was only found in 39 (30%) children. The most common other neuro-ophthalmic manifestations were non-paralytic strabismus (n=33), sixth nerve palsy (n=19) and seventh nerve palsy (n=12). Non-paralytic strabismus was a presenting symptom in only one case. There were 13 ophthalmic surgical procedures required for these children, the most common being strabismus surgery.
We report the types and locations of paediatric intracranial tumours seen in the ophthalmology clinic as well as their neuro-ophthalmic manifestations. Only 30% presented with papilloedema and approximately 10% required an ophthalmic surgical procedure.
本研究考察了一家儿科神经肿瘤中心在大约五年时间里眼科门诊所见儿童颅内肿瘤的情况。以此分析眼科医生在其长期随访中的作用。
编制了一个数据库，涵盖2012年1月至2017年4月期间在神经肿瘤多学科团队（MDT）会议上讨论过的所有儿童。纳入所有经组织学确诊或神经影像学怀疑患有颅内肿瘤且曾在眼科门诊就诊的儿童。进行回顾性病例审查以为每个儿童创建记录。
该数据库包含129名儿童，其中82名（64%）为男孩，47名（36%）为女孩。其中89名（69%）有组织学诊断，40名（31%）经神经影像学怀疑患有肿瘤。最常见的肿瘤部位是后颅窝（n = 54，42%）、间脑（n = 20，16%）和视路（n = 17，13%）。初诊时仅39名（30%）儿童出现视乳头水肿。最常见的其他神经眼科表现为非麻痹性斜视（n = 33）、第六脑神经麻痹（n = 19）和第七脑神经麻痹（n = 12）。非麻痹性斜视仅在1例中作为首发症状出现。这些儿童共需要13次眼科手术，最常见的是斜视手术。
我们报告了眼科门诊所见儿童颅内肿瘤的类型和部位及其神经眼科表现。仅30%的患儿出现视乳头水肿且约10%需要进行眼科手术。
