Sevim Kuyumcu KAVUNCU, Pınar NALÇACIOĞLU, Gölge ACAROĞLU

Clinical and demographic characteristics of childhood neuro-ophthalmology diseases at a tertiary eye care center

Background. To evaluate the demographic, etiological, and clinical properties, as well as the treatment modalities of neuro-ophthalmological diseases in childhood. Methods. We retrospectively analyzed the clinical data of patients younger than 18 years old who were referred to the Neuro-Ophthalmology Department of Ulucanlar Eye Hospital from 2004 to 2019. Results. Of 1,910 patients who presented to the Neuro-Ophthalmology Department, 128 (6.7%) were younger than 18 years old at diagnosis, and their data were analyzed. The three most common diagnoses were congenital optic disc (OD) abnormalities in 43 (33.5%), optic neuropathies in 42 (32.8%), and idiopathic intracranial hypertension in 11 (8.5%) patients. The most frequent symptoms were as follows: decreased visual acuity in 36 (28.1%), headache in 32 (25%), and no symptoms in 19 (14.8%) patients. The best visual prognosis was associated with inflammatory optic neuritis, while hereditary and compressive optic neuropathy resulted in poor visual acuity outcomes. Conclusions. Congenital OD abnormalities and optic neuropathies are the most frequently seen disorders among children with neuro-ophthalmological diseases. Clinicians should also be aware that children without any symptoms may also have neuro-ophthalmological disorders

PDF

___

1. Chinta S, Wallang BS, Sachdeva V, Gupta A, PatilChhablani P, Kekunnaya R. Etiology and clinical profile of childhood pptic nerve atrophy at a tertiary eye care center in South India. Indian J Ophthalmol 2014; 62: 1003-1007.

2. Kong L, Fry M, Al-Samarraie M, Gilbert C, Steinkuller PG. An update on progress and the changing epidemiology of causes of childhood blindness worldwide. J AAPOS 2012; 16: 501-507.

3. Gilbert CE, Canovas R, Hagan M, Rao S, Foster A. Causes of childhood blindness: results from west Africa, south India and Chile. Eye (Lond) 1993; 7(Pt 1): 184-188.

4. Mirdehghan SA, Dehghan MH, Mohammadpour M, Heidari K, Khosravi M. Causes of severe visual impairment and blindness in schools for visually handicapped children in Iran. Br J Ophthalmol 2005; 89: 612-614.

5. Dhiman R, Singh D, Gantayala SP, Ganesan VL, Sharma P, Saxena R. Neuro-ophthalmology at a tertiary eye care centre in India. J Neuroophthalmol 2018; 38: 308-311.

6. Mbekeani JN, Fattah MA, Poulsen DM, et al. Etiology of optic atrophy: a prospective observational study from Saudi Arabia. Ann Saudi Med 2017; 37: 232- 239.

7. Lim SA, Wong WL, Fu E, et al. The incidence of neuro-ophthalmic diseases in Singapore: a prospective study in public hospitals. Ophthalmic Epidemiol 2009; 16: 65-73.

8. Tuğcu B, Özdemir H. Imaging methods in the diagnosis of optic disc drusen. Turk J Ophthalmol 2016; 46: 232-236.

9. Palmer E, Galea J, Crowston JG, Wells AP. Optic nerve head drusen: an update. Neuroophthalmology 2018; 42: 367-384.

10. Charg MY, Pineles SL. Optic disc drusen in children. Surv Ophthalmol 2016; 61: 745-758.

11. Brodsky MC. Congenital optic disk anomalies. Surv Ophthalmol 1994; 39: 89-112.

12. Kidd D, Burton B, Plant GT, Graham EM. Chronic relapsing inflammatory optic neuropathy (CRION). Brain 2003; 126(Pt 2): 276-284.

13. Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2013; 81: 1159-1165.

14. Skidd PM, Lessell S, Cestari DM. Autosomal dominant hereditary optic neuropathy (ADOA): a review of the genetics and clinical manifestations of ADOA and ADOA+. Semin Ophthalmol 2013; 28: 422-426.

15. Urano F. Wolfram syndrome: diagnosis, management, and treatment. Curr Diab Rep 2016; 16: 6.

16. Krupp LB, Tardieu M, Amato MP, et al; International Pediatric Multiple Sclerosis Study Group. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult Scler 2013; 19: 1261-1267.

17. Bouffard MA, The pupil. Continuum (Minneap Minn) 2019; 25: 1194-1214.

18. Barrea C, Vigouroux T, Karam J, Milet A, Vaessen S, Misson JP. Horner syndrome in children: a cinical condition with serious underlying disease. Neuropediatrics 2016; 47: 268-272.

19. Mezer E, Chetrit A, Kalter-Leibovici O, Kinori M, Ben-Zion I, Wygnanski-Jaffe T. Trends in the incidence and causes of severe visual impairment and blindness in children from Israel. J AAPOS 2015; 19: 260-265.e1.

20. Chang MY, Pineles SL. Optic disk drusen in children. Surv Ophthalmol 2016; 61: 745-758.

21. Erkkila H. Optic disc drusen in children. Acta Ophthalmol 1977; 55(Suppl 129): 3-44.

22. Sarkies NJ, Sanders MD. Optic disc drusen and episodic visual loss. Br J Ophthalmol 1987; 71: 537- 539.

23. Davis PL, Jay WM. Optic nerve head drusen. Semin Ophthalmol 2003; 18: 222-242.

24. Hoover DL, Robb RM, Petersen RA. Optic disc drusen in children. J Pediatr Ophthalmol Strabismus 1988; 25: 191-195.

25. Wall M, Kupersmith MJ, Kieburtz KD, et al; NORDIC Idiopathic Intracranial Hypertension Study Group. The idiopathic intracranial hypertension treatment trial: clinical profile at baseline. JAMA Neurol 2014; 71: 693-701.

26. Hamedani AG, Witonsky KFR, Cosico M, et al. Headache characteristics in children with pseudotumor cerebri syndrome, elevated opening pressure without papilledema, and normal opening pressure: a retrospective cohort study. Headache 2018; 58: 1339-1346.

27. Krishnakumar D, Pickard JD, Czosnyka Z, Allen L, Parker A. Idiopathic intracranial hypertension in childhood: pitfalls in diagnosis. Dev Med Child Neurol 2014; 56: 749-755.

28. Gili P, Flores-Rodriguez P, Yanguela J, Herreros Fernandez ML. Using autofluorescence to detect optic nerve head drusen in children. J AAPOS 2013; 17: 568-571.

29. Dai S, Trimboli C, Buncic JR. The optic disc is minimal in children with idiopathic intracranial hypertension. J Child Neurol 2013; 28: 1245-1249.

30. Rasmussen SA, Friedman JM. NF1 gene and neurofibromatosis 1. Am J Epidemiol 2000; 151: 33- 40.

31. Korf BR. Malignancy in neurofibromatosis type 1. Oncologist 2000; 5: 477-485.

32. Campen CJ, Gutmann DH. Optic pathway gliomas in neurofibromatosis type 1. J Chid Neurol 2018; 33: 73-81.

33. Pérez-Cambrodí RJ, Gómez-Hurtado Cubillana A, Merino-Suárez ML, Piñero-Llorens DP, LariaOchaita C. Optic neuritis in pediatric population: a review in current tendencies of diagnosis and management. J Optom 2014; 7: 125-130.

34. Waldman AM, Stull LB, Galetta SL, Balcer LJ, Liu GT. Pediatric optic neuritis and risk of multiple sclerosis: meta-analysis of observational studies. J AAPOS 2011; 15: 441-446.

35. Lucchinetti CF, Kiers L, O’Duffy A, et al. Risk factors for developing multiple sclerosis after childhood optic neuritis. Neurology 1997; 49: 1413-1418.

36. Bonhomme GR, Waldman AT, Balcer LJ, et al. Pediatric optic neuritis: brain MRI abnormalities and risk of multiple sclerosis. Neurology 2009; 72: 881-885.

37. Sun MH, Wang HS, Chen KJ, et al. Clinical characteristics of optic neuritis in Taiwanese children. Eye (Lond) 2011; 25: 1457-1464