EP484 - PAPILLEDEMA IN PATIENTS WITH MULTISYSTEM INFLAMMATORY SYNDROME: IS AN OPHTALMOLOGICAL EXAM USEFUL? (ID 360)
- Alberto Muñoz (Spain)
- Ana Ortueta (Spain)
- Cristina Lopez (Spain)
- Sara Domínguez (Spain)
- Elisa Fernandez (Spain)
- Cinta Moraleda (Spain)
- Daniel Blázquez-Gamero (Spain)
- Luis Prieto (Spain)
- Jaime Carrasco (Spain)
- Angela Manzanares (Spain)
- David Torres (Spain)
- Serena Villaverde (Spain)
- Pablo Rojo (Spain)
- Cristina Epalza (Spain)
Abstract
Backgrounds:
Children with Multisystem Inflammatory Syndrome (MIS-C) associated with SARS-CoV-2 are frequently admitted to the pediatric intensive care unit (PICU) and require vasoactive drugs. However, the outcome of the disease is generally positive. The presence of papilledema has been described in these patients, but its implications are unknown. We aimed to compare MIS-C patients presenting papilledema with those without it and its possible relationship with MIS-C characteristics.
Methods
Patients with MIS-C hospitalized in a tertiary University Hospital in Spain, between January 2021 and October 2021 with an ophthalmological exam performed during the acute phase were included prospectively. Demography, characteristics related to MIS-C evolution, treatment, biological data, neurological and cardiological features were analyzed. Patients with and without papilledema were compared and statistical analysis were performed for selecting factors related to papilledema.
Results:
All the sixteen patients hospitalized with MIS-C diagnosis during the study period had an ophthalmological exam performed: four (25%) had papilledema. Patients with papilledema presented a trend to a longer PICU stay (OR 2.25, 95%CI 0.97-5.20, p=0.057) and oxygen support (OR 11.2, 95%CI 0.86-426, p=0.063). The only two patients requiring intubation and presenting neurologic symptoms requiring Neuropediatric evaluation, presented papilledema (p=0,05). There were no differences in the other evaluated factors (Table 1). Neurologic sequelae were not observed and papilledema resolved in a median of 3.5 weeks (IQR 2.5-6) after admission.
Conclusions/Learning Points:
In our study, papilledema trended to be associated with more severe MIS-C, longer PICU stay, oxygen requirement, need for intubation and neurological symptoms. Papilledema is probably related to central nervous system inflammation. Evaluation of papilledema is an easily available bedside assessment technique that could be included in the evaluation of patients with suspected MIS-C. Its presence could be a predictor of severity.
