NCMP-10. NEURO-OPHTHALMOLOGICAL FINDINGS IN CHILDREN AND ADOLESCENTS WITH MEDULLOBLASTOMA - A RETROSPECTIVE ANALYSIS

Abstract BACKGROUND Medulloblastoma represents the most common malignant pediatric brain tumor. Ophthalmic complications are possible sequelae. METHODS Pediatric medulloblastoma (MB) patients treated at Medical University of Vienna from January 2012 to August 2021 were analyzed and their last ophthalmic assessment was reviewed. RESULTS Fifty-six MB could be included (71.4% non-WNT/non-SHH, 16.1% SHH-activated, 8.9% WNT-activated, 3.6% non-specified). Mean age diagnosis 7.2 years (range 0-19). Median follow-up ophthalmological 19.7 months 0.1-93.2). Thirty-four children underwent tumor resection our hospital, localizations were: vermis (55.9%), floor 4th ventricle (26.5%), cerebellar hemispheres (11.8%), lateral recess (5.9%). Symptoms presentation evaluable for 51 children: 92.2% had symptoms elevated intracranial pressure, 76.5% ataxia 21.6% visual disturbances. Postoperative posterior fossa syndrome observed in 11.1% 54 children. 98.2% chemotherapy as part initial treatment all older than four (85.7%) received postoperative irradiation fossa. In 13 (23.2%) intraventricular applied. At 21 experienced relapse after primary treatment. final assessment, frequent neuro-ophthalmological abnormalities included: oculomotor disturbance (75%), esotropia (35.7%) including abducens palsy (12.5%), other cranial nerve palsies (21.4%), horizontal gaze-evoked nystagmus (51.8%), spontaneous (16.1%), ocular tilt reaction optic disc (14.3%). Good acuity (≥20/25) maintained 62.5% patients. Visual field optical coherence tomography successfully performed 75% 66.1% patients, respectively. Optic pathway lesions detected 4 (7.1%), two cases with occipital metastases, one metastasis leptomeningeal carcinomatosis. Orthoptic prisms strabismus surgery required 14.3% 7.7% children, CONCLUSION Children frequently suffer late-effects. Regular monitoring is warranted initiate appropriate management.