Visual outcome analysis in patients with posterior fossa tumours undergoing surgical treatment

Abstract

Background: In the past, there were studies done to assess visual outcomes like visual acuity, fundoscopic findings and visual field mainly in pediatric patients with posterior fossa tumours (PFT). We assessed the above parameters pre- and post-operatively in all age group patients including both extra and intra-axial PFT. We also assessed visual outcome in patients with or without hydrocephalus. Objectives: To analyze “visual outcomes in patients with posterior fossa tumours undergoing surgical treatment”. The effect of hydrocephalus on the visual outcome was also analyzed. Materials and Methods: This prospective study including 107 patients with PFT undergoing definitive surgery was conducted in the Department of Neurosurgery at Dr Rmlims, Lucknow. Pre-op and post-op (six weeks after tumour resection) visual examinations were done and compared. Results: A shifting trend towards normalization of visual acuity (VA) was seen post-surgery in all age groups. Overall improvement was seen in the majority of cases having pupil normal size sluggish reactive (NSSR) after surgery. Papilledema improved in the majority of patients in all age groups and patients having hydrocephalus. Colour vision and night vision also improved in the majority. The field of vision cut was not improved postoperatively in the majority. Conclusion: Visual parameters like visual acuity, pupil size and reactivity to light; colour vision and night vision were improved significantly after surgery whereas cut field of vision did not improve. All fundoscopic findings like papilledema, retinal venous dilation and retinal splinters haemorrhage disappeared in a significant number of patients post-operatively. In cases with obstructive hydrocephalus, these parameters also improved significantly after Ventriculo-peritoneal shunt/ ETV or definitive surgery.