• Annals of Saudi medicine · Nov 2022

    Review

    The prevalence of strabismus and visual outcomes in children with hydrocephalus and a ventriculoperitoneal shunt: medical record review.

    • Saif Saleh AlObaisi, Bashair Nasser Alnasser, Hana Abdulaziz Almuhawas, Saja Abdulrahmn Alhoshan, Modhi Abdullah Alamer, Rana Mohammad Alshaye, Sulaiman Abdulaziz Aldakhil, and Manal Mosaad Alabdulmunem.
    • From the Department of Pediatric Surgery, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
    • Ann Saudi Med. 2022 Nov 1; 42 (6): 391396391-396.

    BackgroundMany ophthalmological complications have been associated with hydrocephalus (HC), including ocular motility disorders, visual field defects, optic atrophy, and loss of visual acuity. No studies have investigated the prevalence of strabismus and visual outcomes of children with congenital HC after ventriculoperitoneal (VP) shunt in Saudi Arabia.ObjectivesEstimate the frequency of strabismic children diagnosed with HC who underwent a VP shunt procedure.DesignMedical record review SETTING: Tertiary care center PATIENTS AND METHODS: We reviewed the files of all pediatric patients diagnosed with hydrocephalus before the age of 2 years and treated with shunts during the period 2010 to 2020 at our institution.Main Outcome MeasuresStrabismus types and ophthalmic assessment (visual state, outcomes, and ocular motility state).Sample Size And Characteristics190 children; 98 (51.5%) males.ResultsEighty-nine (46.8%) had congenital HC followed by intraventricular hemorrhage 36 (18.9%); 74 (38.9%) patients had regular follow-ups in ophthalmology. Sixty-five (34.2%) patients had no ophthalmic assessment or fundus examination records, while 63 (33.1%) were diagnosed with strabismus. At the initial assessment, 26 (13.6%) patients had exotropia (XT). At the final assessment, 7 (3.6%) patients had XT. The association between VP shunt and strabismus was statistically significant, (χ2=6.534, df=1, P<.01).ConclusionMore than one-third of children diagnosed with HC who had surgical treatment in a tertiary hospital did not have any records of ophthalmic assessment, which highlights the need to implement a specific ophthalmological examination protocol in patients with HC. Further studies are needed to analyze the association between VP shunt and strabismus.LimitationsEvaluating the ocular state and visual function before and after VP shunt was not possible.Conflict Of InterestNone.

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