Long-term ophthalmological follow-up of children with Parinaud syndrome

Ophthalmic Surg Lasers Imaging. 2010 Jul-Aug;41(4):467-71. doi: 10.3928/15428877-20100426-02.

Abstract

Background and objective: To assess the long-term ophthalmological outcome of Parinaud syndrome.

Patients and methods: The files of 6 children with tumor-related Parinaud syndrome diagnosed and observed from 2000 to 2007 were reviewed. All had papilledema indicating increased intracranial pressure.

Results: Mean presentation-to-diagnosis delay was 3.6 weeks. Treatment consisted of surgical shunting and complete or partial resection with adjuvant chemotherapy (n = 4) and radiation (n = 3). Visual acuity remained stable or improved in 8 of 9 eyes with 20/30 visual acuity at diagnosis; improved bilaterally in 1 patient from 20/100 to 20/25; and deteriorated bilaterally in 1 patient from 20/30 and 20/200 to counting fingers and hand motions, respectively. The most improvement was achieved within 4 months. Findings at follow-up (mean: 4.2 years) included up gaze limitation (minimal in 2 patients), abnormal convergence, convergence retraction nystagmus, and light-near dissociation. One child had bilateral optic atrophy.

Conclusion: Children with tumor-related Parinaud syndrome tend to have subtle but measurable residual ophthalmological findings years after diagnosis and treatment.

MeSH terms

  • Adolescent
  • Astrocytoma / pathology
  • Astrocytoma / therapy
  • Chemotherapy, Adjuvant
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Germinoma / pathology
  • Germinoma / therapy
  • Humans
  • Intracranial Pressure
  • Male
  • Ocular Motility Disorders / diagnosis*
  • Ocular Motility Disorders / physiopathology
  • Papilledema / diagnosis*
  • Pinealoma / pathology*
  • Pinealoma / therapy
  • Radiotherapy
  • Teratoma / pathology
  • Teratoma / therapy
  • Ventriculoperitoneal Shunt
  • Vision Disorders / diagnosis*
  • Visual Acuity / physiology