This article is part of the supplement: 53rd Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida .

Oral presentation

Visual field examination for children with shunted hydrocephalus

Diana Rudolph¹, Ina Sterker², Holger Till¹, Gerd Gräfe¹ and Christian Geyer¹

¹  Department of Pediatric Surgery, University of Leipzig, Germany (Liebigstraße 20a, 04103 Leipzig), Germany

²  Department of Ophthamology, University of Leipzig, Germany (Liebigstraße 20a, 04103 Leipzig), Germany

author email corresponding author email

from 53rd Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida
Belfast, UK. 24-27 June 2009

Cerebrospinal Fluid Research 2009, 6(Suppl 2):S8doi:10.1186/1743-8454-6-S2-S8

The electronic version of this abstract is the complete one and can be found online at: http://www.cerebrospinalfluidresearch.com/content/6/S2/S8

Published:

27 November 2009

© 2009 Rudolph et al; licensee BioMed Central Ltd.

Background

In conjunction with hydrocephalus many ophthalmological abnormalities are described. Results of visual field diagnosis remain a matter of further discussion. The aim of this study was to investigate visual field deficits of children with shunted hydrocephalus.

Materials and methods

From Dec. 2007 until Dec. 2008 all children over 6 years of age treated with hydrocephalus in our institute were included. The children received an ophthalmological investigation concerning strabismus and binocular function, ophthalmoscopy, visual acuity and refraction. The special focus was visual field diagnosis, which we made with all children having cognitive conditions. The investigation was made by using the 'Goldmann' - perimeter (static perimetry). Children with and without visual field defects were compared concerning age at the time of ophthalmological examination, genesis of hydrocephalus and FOH of current CT or MRI scans.

Results

Fifty-six children were investigated. There were 24 females and 32 males. The mean age was 14.7 years. The following orthoptic pathologies were diagnosed: 29 children had strabismus, 17 exotropia, 12 esotropia, 4 children hypotropia, 2 hypertropia and 3 children heterophoria. Nystagmus was found in 10 children. The ocular fundus investigation showed 13 children with optic nerve atrophy.

A visual field diagnosis was possible with 42 of the 56 patients. The investigation was incomplete in 14 patients with cognitive deficits or inadequate compliance. 24 of 42 children showed a concentric visual field constriction between 10° and 50° out of the centre. Children with visual field deficits were older than those with normal visual field (p = 0.1). Nine of 10 children with postmeningitic hydrocephalus had a visual field defect (p = 0.035). Children with visual field defects had a significant higher FOH (p = 0.017).

Conclusion

Our results suggest that children with shunted hydrocephalus have a superior risk of having ophthalmological abnormalities. Visual field deficit is often a problem of these patients. Visual field diagnostic can complete the ophthalmological monitoring in patients with hydrocephalus especially in patients with large ventricles. Children with postmeningitic hydrocephalus should be monitored more frequently and intensively.

Have something to say? Post a comment on this article!