title: Paediatric patients with sudden vision impairment - An overview of MRI findings.
abstract: OBJECTIVE
  Sudden visual impairment in children occurs sporadically but, when present, needs urgent attention. Optimal management strategies and timely recognition are required. Often psychogenic disorders are the cause in school-age children; however, this is a diagnosis of exclusion. Therefore, MRI plays an important role in ruling out pathology along the optic pathways or helping with the diagnosis of underlying life threatening diseases, such as hydrocephalus or intracranial mass. The purpose of this study was first to evaluate non-traumatic (tumoural and non-tumoural) causes of acute vision impairment; and, second, to assess whether conventional cerebral and orbital MR imaging is helpful for children with sudden visual impairment.
  
  
  METHODS
  We retrospectively analysed the MRI scans and clinical findings of 95 children (47 male, 48 female; median age: 12.5 years, range: from 2 to 17 years) who presented symptoms of monocular or bilateral acute vision impairment.
  
  
  RESULTS
  Patients with acute visual impairment were usually older than 7 years. In 36% of the patients a correlation between the MRI findings and the clinical symptoms was found. The most common causes of visual impairment were: infectious diseases (16%), migraine (12%), autoimmune diseases (11%), optic nerve neuritis with unknown aetiology (8%), neoplasms (8%), idiopathic intracranial hypertension (5%) and orthostatic hypotension (4%). Still, in 23% of the patients the cause remained unclear.
  
  
  CONCLUSIONS
  Acute vision impairment is frequently caused by infectious diseases, migraine, autoimmune diseases or tumours in children. MRI is highly recommended, especially in the case of children younger than 5 years of whom clinical assessment can be difficult.
authors.affiliation: Institute of Neuroradiology, Hospital of Goethe University, Frankfurt am Main, Germany. Electronic address: stephanie.lescher@kgu.de.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lescher
authors.affiliation: Institute of Neuroradiology, Hospital of Goethe University, Frankfurt am Main, Germany. Electronic address: valerie-w@gmx.de.
authors.forename: Valerie
authors.initials: V
authors.lastname: Wickmann
authors.affiliation: Department of Paediatric Neurology, Hospital of Goethe University, Frankfurt am Main, Germany. Electronic address: Peter.Hofstetter@kgu.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Hofstetter
authors.affiliation: Institute of Neuroradiology, Hospital of Goethe University, Frankfurt am Main, Germany. Electronic address: Luciana.Porto@kgu.de.
authors.forename: Luciana
authors.initials: L
authors.lastname: Porto
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D015817:Eye Infections / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000000981:diagnostic imaging*; D007024:Hypotension, Orthostatic / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D009902:Optic Neuritis / Q000150:complications / Q000000981:diagnostic imaging*; D011559:Pseudotumor Cerebri / Q000150:complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: MRI; Paediatric patients; Vision impairment