Visual Outcomes, Visual Fields, and Optical Coherence Tomography in Paediatric Craniopharyngioma

Mediero, Soraya; Noval, Susana; Bravo-Ljubetic, Luciano; Contreras, Inés; Carceller, Fernando

doi:10.3109/01658107.2015.1039549

Cited by 20 publications

(22 citation statements)

References 37 publications

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“…In contrast, Jung et al reported the mean age was 12 years [12]. There was a male preponderance in our study population, which is also consistent with other pediatric craniopharyngioma studies [8,11-13]. In contrast, Drimtzias et al and Bialer et al from the United Kingdom and Israel respectively, reported an equal ratio of males and females [6,9].…”

Section: Discussionsupporting

confidence: 89%

“…Improved visual outcome is the main concern for ophthalmologists and neurosurgeons managing pediatric craniopharyngioma. Table 5 summarizes published reports on visual presentation and outcome in patients with pediatric craniopharyngioma from Asian countries, the United Kingdom, Spain, Israel, and France, as well as those included in our study [6, 8-13].…”

Section: Discussionmentioning

confidence: 99%

“…The mean age of presentation was 9.5 (4.2) years in our study. In the majority of the studies reviewed, the mean age of presentation was less than 10 years [6,8,9,11-13]. In contrast, Jung et al reported the mean age was 12 years [12].…”

Section: Discussionmentioning

confidence: 99%

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Visual Presentation and Factors Affecting Visual Outcome in Children with Craniopharyngioma in East Coast States of Peninsular Malaysia: A Five-year Review

Mohd-Ilham

Ahmad-Kamal

Hitam

et al. 2019

Cureus

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Purpose To describe the visual presentation and factors affecting visual outcome in pediatric patients treated for craniopharyngioma at a referral center in the East Coast states of Peninsular Malaysia. Methodology A retrospective review of medical records of children aged 17 years and below who had been treated for craniopharyngioma in Hospital Universiti Sains Malaysia from January 2014 to December 2018. The data collected included age, gender, presenting symptoms and duration, visual acuity, visual fields, color vision, light brightness, relative afferent pupillary defects, fundus examination and cranial nerves examination. The best corrected visual acuity during presentation, and after a one-year post-operative period, was documented. Records on investigations, surgical procedures, therapeutic modalities and recurrences were also reviewed. Results A total of 11 pediatric patients (22 eyes) were recruited. Fifty percent presented with optic atrophy. The mean duration of the onset of symptoms before consultation was 22.3 (24.5) months. A final best corrected visual acuity of 6/12 (20/40) or better was observed in 50% of the patients. There was a statistically significant association between presenting visual acuity, optic nerve function and visual field defects, and the final visual outcome. Conclusions Visual presentations in our study were fairly similar to previous reported studies. One-third presented late with permanent visual loss. Almost half had significant visual impairment after one-year post-operative period. Significant associations were observed between presenting visual acuity, duration of symptoms, impairment of optic nerve function tests, and visual field defects during presentation, and final visual acuity at one year after treatment.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Visual Presentation and Factors Affecting Visual Outcome in Children with Craniopharyngioma in East Coast States of Peninsular Malaysia: A Five-year Review

Mohd-Ilham

Ahmad-Kamal

Hitam

et al. 2019

Cureus

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“…RNFL thinning reflects irreversible retinal ganglion cell damage, which usually occurs after prolonged compression of the visual pathways. [4924] Hence, any structural damage of the retina detectable with OCT predicts the existence of irreversible injury at the optic chiasm/optic tracts that will associate visual loss to be confirmed on standard automated perimetry[11224] Despite the apparent partial visual recovery observed on our patient's initial postoperative perimetry, the OCT already reflected structural damage in the retinal ganglion cells, which had advanced with respect to the preoperative study and anticipated a long-term worsening of visual function.…”

Section: Discussionmentioning

confidence: 90%

Intrachiasmatic craniopharyngioma: Assessment of visual outcome with optical coherence tomography after complete surgical removal

Gil-Simoes¹,

Pascual²,

Casas³

et al. 2019

Surg Neurol Int

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Background:Optic chiasm invasion by a craniopharyngioma (CP) is exceptional. Surgical treatment of intrachiasmatic CPs associates a high risk of chiasm injury, which should be properly addressed before surgery.Case Description:We present a 46-year-old woman admitted to the hospital with low visual acuity (0.1 in the right eye and 0.5 in the left) and a severe defect in her visual fields, in addition to headaches, diabetes insipidus, and a long-term depressive disorder. Her visual deficit progressed from a right homonymous temporal inferior quadrantanopia to an almost complete loss of vision in both eyes that only spared the upper nasal quadrants. Brain MRI showed a rounded third ventricle tumor with a potbelly expansion of the optic chiasm, suggesting chiasm invasion by the tumor. Optical coherence tomography (OCT) showed the thinning of the retinal nerve fiber layer (RNFL) in the superior and temporal wedges of the right eye and in the temporal wedge of the left one. The tumor was completely removed by employing a frontotemporal craniotomy and a translamina terminalis approach. Histological analysis showed a squamous-papillary CP. Postoperatively, a significant worsening of the visual defect was evidenced on the perimetry, which was related to a marked RNFL atrophy measured with OCT, as compared to the preoperative study. The poor long-term visual outcome in this patient correlated well with the results of postoperative OCT.Conclusions:Preoperative analysis of retinal atrophy with optic coherence tomography allows a reliable assessment of the patient's visual outcome in CPs involving the optic chiasm.

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“…Thus, pRNFL values within normal values in patients with visual fields due to chiasmal tumours have been shown to predict visual improvement after treatment. This predictive role has been established in adults with pituitary adenoma [ 15 ] and craniopharingioma [ 16 ]. Therefore, perimetry would seem to be better than OCT evaluation of the pRNFL to detect early compression of the visual pathway in order to achieve visual improvement after treatment, both after the initial diagnosis or after recurrences.…”

Section: Discussionmentioning

confidence: 99%

Macular ganglion cell complex thinning in children with visual field defects due to central nervous system pathology

Noval

Henríquez-Recine

Contreras

et al. 2019

Eye

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Purpose To study the relationship between macular ganglion cell complex (GCC) thickness and visual field defects (VFD) caused by central nervous system (CNS) lesions in children and evaluate the possibility of predicting VFD according to GCC maps. Methods The GCC maps of a group of children with VFD due to CNS lesions with respect of the vertical meridian in at least one eye (study group), as well as of children with other neuro-ophthalmological problems and healthy children were presented to two masked evaluators, who were asked to predict the patients’ VFD on the basis of GCC damage: the evaluators classified VFD as normal, hemianopia (homonymous or heteronymous) or diffuse. Results Seventeen patients were included in the study group, with a median age of 12 years. Fifteen had brain tumours and two epilepsy. The mean MD of the affected hemifields was −26.00 dB (SD 7.89 dB) versus −5.51 dB (SD 3.52 dB) for the nonaffected hemifields, p < 0.001. The mean GCC thickness was of 56.04 μm (SD 11.95 μm) in the affected hemiretinas versus 74.31 μm (SD 10.64 μm) for the non-affected, p < 0.001. Kappa coefficients between VFD and those estimated by the evaluators were 0.705 and 0.658 ( p < 0.001) for evaluators 1 and 2. Conclusions GCC thickness can reflect damage to the visual pathway and GCC maps may be useful to identify chiasmal and retrochiasmal lesions, since GCC atrophy in most of these cases respects the vertical meridian. GCC maps might be used as a surrogate marker for visual damage in patients unable to perform perimetry.

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Visual Outcomes, Visual Fields, and Optical Coherence Tomography in Paediatric Craniopharyngioma

Cited by 20 publications

References 37 publications

Visual Presentation and Factors Affecting Visual Outcome in Children with Craniopharyngioma in East Coast States of Peninsular Malaysia: A Five-year Review

Visual Presentation and Factors Affecting Visual Outcome in Children with Craniopharyngioma in East Coast States of Peninsular Malaysia: A Five-year Review

Intrachiasmatic craniopharyngioma: Assessment of visual outcome with optical coherence tomography after complete surgical removal

Macular ganglion cell complex thinning in children with visual field defects due to central nervous system pathology

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