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The purpose of this study was to evaluate the prevalence of strabismus in NF1 by comparing children with normal neuroimaging to those with optic pathway glioma. The study included 236 children with NF1, of which 38 were excluded with no MRI data leaving 198 included children (109 male). Normal MRI scans were reported in 121 and 77 had optic pathway glioma involving the optic nerve and / or optic chiasm. Mean age at presentation was 6.3±4.7 years with mean follow-up of 4.8±3.1 years. Strabismus was found at presentation in 21 (11%); seven with normal MRI and 14 with glioma. At follow-up, strabismus was found in 29 (15%). Prevalence of strabismus was higher in those with glioma. Strabismus included 15 exotropia, 11 esotropia and three vertical strabismus. The most common type was sensory strabismus. The authors conclude children with NF1 and optic pathway glioma are approximately four times more likely to develop strabismus than those with NF1 without tumour of the pathway.

Prevalence of strabismus among children with neurofibromatosis type 1 disease with and without optic pathway glioma.
Dotan G, Qureshi HM, Toledano-Alhadef H, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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