Transient binocular visual loss: a rare presentation of ventriculoperitoneal shunt malfunction

Sunil, M; Payne, Catherine; Panda, Mukta

doi:10.1136/bcr.10.2011.4929

Cited by 5 publications

(17 citation statements)

References 32 publications

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“…Posterior visual pathway (e.g., homonymous hemianopsia, cortical visual loss) involvement is less common. 1 Our patient experienced the common symptoms of shunt failure in addition to decreased VA, diplopia, vertical gaze palsy, and nystagmus.…”

Section: Discussionmentioning

confidence: 71%

“…Following valve replacement, the patient experienced improvement of his symptoms without recurrence at one-year followup. 1 Although both cases describe symptomatic improvement after shunt revision, neither case reports evidence of transependymal oedema.…”

Section: Discussionmentioning

confidence: 94%

“…4 Treatment involves shunt revision or removal, typically resulting in rapid improvement. 1,3 Dadlani et al described a patient with progressive decrease in VA to light perception bilaterally due to shunt malfunction. Their patient did not exhibit signs of increased intracranial pressure despite ventriculomegaly.…”

Section: Discussionmentioning

confidence: 99%

“…Less commonly, involvement of the optic apparatus, including the optic nerves, optic tracts, optic chiasm, or optic radiations can result in visual field defects and decreased visual acuity (VA). 1 We report an unusual case of acute onset vision loss due to transependymal oedema secondary to VPS malfunction that resolved clinically and radiographically after revision of the shunt and remained without recurrence at 6-month follow-up. To the best of our knowledge, this is the first such case in the transependymal oedema involving the visual pathway secondary to VP shunt malfunction in the English language ophthalmic literature.…”

Section: Introductionmentioning

confidence: 89%

“…Ventriculoperitoneal shunt (VPS) malfunction may occur secondary to infectious or mechanical etiologies. Shunt infections occur in approximately 11-19.7% of patients 1 whereas mechanical complications, including shunt obstruction, fracture, or displacement, occur in up to 45% of patients who require revision. 2 The most common symptoms are related to increased intracranial pressure (e.g., headache, nausea, and vomiting or blurred vision from papilloedema).…”

Section: Introductionmentioning

confidence: 99%

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Reversible Vision Loss Due to Transependymal Oedema of the Optic Apparatus Secondary to Ventriculoperitoneal Shunt Malfunction

Nguyen

Ponce

Vickers

et al. 2019

Neuro-Ophthalmology

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A 29-year-old male with a history of pilocytic astrocytoma status post-multiple ventriculoperitoneal shunt (VPS) revisions presented with vision loss, ocular motor deficits, and headaches. His shunt was revised but he experienced persistent vision loss despite resolution of his headaches and diplopia. Magnetic resonance imaging (MRI) of the head revealed hydrocephalus and T2 hyperintensity consistent with transependymal oedema surrounding the midbrain, pons, and optic apparatus. His shunt was again revised, but was complicated by an infection that required removal. He underwent an endoscopic third ventriculostomy and an external ventricular device was temporarily placed. Repeat MRI revealed marked improvement of the transependymal oedema and hydrocephalus. His vision returned to baseline and remained stable at 6-months follow-up.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reversible Vision Loss Due to Transependymal Oedema of the Optic Apparatus Secondary to Ventriculoperitoneal Shunt Malfunction

Nguyen

Ponce

Vickers

et al. 2019

Neuro-Ophthalmology

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Visual outcome after endoscopic third ventriculostomy for hydrocephalus

et al. 2017

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Permanent Visual Impairment due to Delayed Diagnosis of Shunt Malfunction in Case of Lack of Typical Features of Increased Intracranial Pressure and Unchanged Ventricular Size

Qiu

Yang

et al. 2022

Pediatr Neurosurg

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Objective: We present the clinical features, imaging and management of five cases of visual impairment as the primary manifestation ventriculoperitoneal (V-P) shunt malfunction. Methods: We retrospectively reviewed the medical records of 126 patients of V-P shunt malfunction in Shanghai Children's Medical Center between 2015 and 2020. Medical records including all hospital admissions were reviewed and follow-up data were collected. Results: Five children (3.97%) had visual impairment as the primary manifestation of V-P shunt malfunction, with a mild or no headache. Four broken distal shunt catheters and one proximal catheter blockage were confirmed intra-operatively and cured by surgery. None of the patients had a definite improvement in ophthalmic examinations after 4 to 52 months of follow-up. Conclusion: Visual impairment as the primary manifestation of V-P shunt malfunction was uncommon and could be easily missed or misdiagnosed as the only problem for lack of typical features of increased intracranial pressure (ICP) and unchanged ventricular size. Earlier definitive diagnosis and surgical intervention could prevent a further development of the visual loss caused by V-P shunt malfunction.

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Transient binocular visual loss: a rare presentation of ventriculoperitoneal shunt malfunction

Cited by 5 publications

References 32 publications

Reversible Vision Loss Due to Transependymal Oedema of the Optic Apparatus Secondary to Ventriculoperitoneal Shunt Malfunction

Reversible Vision Loss Due to Transependymal Oedema of the Optic Apparatus Secondary to Ventriculoperitoneal Shunt Malfunction

Visual outcome after endoscopic third ventriculostomy for hydrocephalus

Permanent Visual Impairment due to Delayed Diagnosis of Shunt Malfunction in Case of Lack of Typical Features of Increased Intracranial Pressure and Unchanged Ventricular Size

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