Young patients with spina bifida at risk for ophthalmic complications
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Young patients with spina bifida present with ophthalmic complications at a high rate, according to a poster presented at the virtual American Association for Pediatric Ophthalmology and Strabismus annual meeting.
Using a national spina bifida database, researchers in Ireland conducted a retrospective chart review from 2009 to 2019 evaluating ophthalmic manifestations in patients with open spina bifida defects and complicated closed defects. A total of 240 patients aged 1 to 10 years were included.
“This is the largest recent study of the ophthalmic complications of spina bifida. It highlights the risk of ophthalmic complications in this population as well as the central role for the ophthalmologist and multidisciplinary team input,” Treasa Murphy, MB, BMBB, BAO, MRCSIOphth, said.
In all, 155 patients (64.58%) underwent a shunt procedure, with the average time from birth to procedure being 28.025 days. Forty-nine patients (20.41%) had an episode of papilledema, and 26 patients (10.83%) developed optic nerve atrophy over the follow-up period. Eight patients had more than one shunt revision surgery.
“There is a greater risk of optic nerve deficits, nystagmus, cranial nerve VI palsy and refractive error in the shunt population,” Murphy said. “More than two shunt revision surgeries are associated with an increased risk of papilledema, optic atrophy and strabismus.”
In 28.75% of patients, manifest or latent strabismus was identified, with 57.98% of these patients presenting with esotropia or esophoria. Patients with a thoracic spinal defect demonstrated a statistically significant increased risk for strabismus (P = .026).
The average visual acuity among participants was 0.18 logMAR, and there was no significant correlation between the development of amblyopia and shunt insertion or thoracic defect, according to the poster.
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Murphy T, et al. Ophthalmic complications of spina bifida: A 10-year review of the Irish experience. Presented at: American Association for Pediatric Ophthalmology and Strabismus annual meeting; April 9-11, 2021 (virtual meeting).
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