[Visual motor and visual defects in spina bifida]. / Problemi visivi e visuomotori nella Spina Bifida.

Among the numerous problems that Spina Bifida (SB) patients are faced with, impairments to the visual apparatus are often considered late and are not covered extensively in the literature. At the Pediatric Department of the University of Padua, an assessment of the visual function of 59 SB patients between 5 months and 26 years of age (29 male and 30 female) has been carried out by means of an ophthalmologic protocol As far as the alteration of the exstrinsic ocular mobility is concerned, 44% (26/59) of our patients revealed a manifest squint and only 3% (two patients) suffered from a latent squint. The most frequent type is a convergent squint (80%). The assessment of visual acuity made through Optotype was good in 82% of the cases (unlike what is commonly reported in the literature) and mild in 18%. None of the patients manifested hypovision. Refraction defects were present in 59% (34/59) of the patients. Regular ophthalmologic evaluations from birth or from diagnosis allow ophthalmologic treatments that are tailored to children suffering from SB and also enable them to reach and maintain a good visual standard and to observe the subtle symptoms of endocranial hypertension sooner. An early discovery and correct treatment of visual problems improves cognitive and motive performance as well as the autonomy of SB patients.

[Visual motor and visual defects in spina bifida]. / Problemi visivi e visuomotori nella spina bifida.

Among the numerous problems that spina bifida (SB) patients are faced with, impairments to the visual apparatus are often considered late and are not covered extensively in the literature. At the Pediatric Department of the University of Padua, an assessment of the visual function of 59 SB patients between 5 months and 26 years of age (29 male and 30 female) has been carried out by means of an ophthalmologic protocol. As far as the alteration of the exstrinsic ocular mobility is concerned, 44% (26/59) of our patients revealed a manifest squint and only 3% (two patients) suffered from a latent squint. The most frequent type is a convergent squint (80%). The assessment of visual acuity made through Optotype was good in 82% of the cases (unlike what is commonly reported in the literature) and mild in 18%. None of the patients manifested hypovision. Refraction defects were present in 59% (34/59) of the patients. Regular ophthalmologic evaluations from birth or from diagnosis allow ophthalmologic treatments that are tailored to children suffering from SB and also enable them to reach and maintain a good visual standard and to observe the subtle symptoms of endocranial hypertension sooner. An early discovery and correct treatment of visual problems improves cognitive and motive performance as well as the autonomy of SB patients.

[Intraorbital tumors in children. Two cases and review of the literature]. / Neoplasie endorbitarie in età evolutiva. Due casi e revisione della letteratura.

Also in childhood, the orbital cavity is a possible place for different kinds of lesions. The recent contribution of magnetic risonance imaging (MRI) enables a more accurate differential diagnosis of intraorbital pathology. The clinical and neuroradiological data of two new patients affected respectively by intraorbital meningioma and schwannoma are presented. Both patients showed exophthalmos without pain and were treated with surgery. The different etiologies of intraorbital lesions, i.e. vascular, neoplastic, inflammatory, cystic and malformative are analyzed. Sometimes the case history and neuroradiological assessment alone enable a correct diagnosis. More often, however, only surgery reveals the exact nature of the disease. The age of the patient too can represent a criteria for a possible differential diagnosis.

Retinoblastoma. Combined treatment of 21 cases. Critical review of the results.

The authors report their experience in the treatment of 21 children affected by retinoblastoma. There were 14 bilateral and seven unilateral cases of retinoblastoma; mean age at diagnosis was 16 months in males (16 patients) and 30 months in females (five patients). They were all staged according to Howarth et al. (1980) and treatment was correlated to the various stages. The treatment protocol was determined by a group of co-workers at the University of Padova. Among the 35 affected eyes, 26 were enucleated and the others were treated without surgery. One patient died of cerebral metastases and two patients are affected by a second tumor with an unfavorable prognosis for survival. Two other patients are affected by chronic liver disease, probably due to chemotherapy. The authors confirm the importance of early diagnosis and prompt and effective treatment in children affected by retinoblastoma. They also stress that recently developed genetic techniques allow diagnosis of retinoblastoma even before the symptoms appear.