Exploring the effect of visual telerehabilitation program on visual perception in children with hemianopia consecutive to a brain tumour, preliminary results of a pilot study

Abstract Brain tumours (BT) in children often lead to visual impairment, which represents a significant morbidity for long-term survivors. A recent Children Cancer Survivor Study showed that 22.5% of patients with astroglial tumours had visual impairment 5 years after the diagnosis. In the pediatric population with hemianopia, there are no standardized protocols for managing vision loss. In this pilot study, a 6-week home-based visual telerehabilitation program (VTP) evaluated visual changes in 10 children with hemianopia consecutive to a BT. METHOD: The study included 10 patients aged 8-18 years old with hemianopia consecutive to a pediatric BT. Five patients had a chiasmatic tumour (CT), other 5 had a tumour located outside of the chiasm (OCT). Patients followed a 6-week VTP on a virtual reality device at home with remote control of the device from the UHN laboratory. Visual assessments performed at baseline, 2, 4, 6 weeks with follow-ups at 1 and 6 months to check the visual field, contrast sensitivity and reading speed. A quality-of-life (QoL) questionnaire was also filled by patients and parents at every visit. RESULTS: The preliminary results of 8 patients have been analyzed. Four patients (3 CT, 1 OCT) showed visual field improvement with increased luminance perception in the monocular Humphrey test. Four patients (2 CT, 2 OCT) showed visual field improvement in the binocular Esterman field analysis. Reading speed improved in 6 patients (3CT, 3OCT). All patients had significant improvement in contrast sensitivity and QoL. CONCLUSION: Preliminary results of this study showed that this VTP was feasible in children. The program was effective, especially for patients with CT in improving visual field with an impact on contrast sensitivity, reading speed and QoL. Further studies are in development to confirm these results and identify the most appropriate schedules to optimize visual outcomes. POSTER CATEGORIES: BS = BASIC SCIENCE CS = CLINICAL SCIENCE RO = RADIATION ONCOLOGY MO = MEDICAL ONCOLOGY M = MISCELLANEOUS POSTER/TRAVEL AWARDS provided by: BTFC = Brain Tumour Foundation of Canada OHRI = Ottawa Hospital Research Institute