Evaluation of visual and oculomotor outcome in patients with posterior fossa tumours

Abstract

Objective: To evaluate and compare visual and oculomotor outcomes in patients with posterior fossa tumours.
Methods: Prospective Observational Study including 42 patients with posterior fossa tumours who underwent either CSF diversion or definitive surgery at RML Hospital, Delhi, between July 2021 and January 2023. Preoperatively and postoperatively, a neurological and visual assessment was done. The visual evaluation consisted of Visual acuity, Fundus, Diplopia charting, Perimetry, and forced duction test. Preoperative and Postoperative visual outcome was compared and statistically analysed. Visual outcomes are also compared according to the final histological diagnosis.
Results: 30 cases underwent CSF diversion, and 12 cases received definitive surgery. The visual acuity was divided into three groups i.e. Good, Fair, and Poor. The visual acuity was good and fair in 2.5% and 92.8% of the cases pre-operatively, and postoperatively, it was good in 26.2% and fair in 69% cases, respectively. The difference was found to be statistically significant (P < 0.01). Papilledema decreased from grade 2 to grade 1 in 50% of cases postoperatively, while it was absent in 87.5% of the cases at three months of follow-up. Diplopia was absent in all of the cases at follow-up at 3 months.
Conclusions: If treated timely, posterior fossa tumours are typically associated with a positive prognosis. The majority of patients with posterior fossa tumours had good visual outcomes with the use of CSF diversion, proper microsurgical procedures, and follow-up.