Poster 8

Feb 18, 2017 by AAPOS editor in  Poster Session 1

Long-Term Visual Outcomes of Craniopharyngioma in Children

Michael Wan

The Hospital for Sick Children and The University of Toronto
Toronto, Ontario, Canada

Introduction:  Craniopharyngiomas in children commonly cause visual impairment. The purpose of this study is to report long-term visual outcomes in a cohort of pediatric craniopharyngioma patients.

Methods:  The study design is a retrospective chart review of craniopharyngioma patients from a single tertiary care pediatric hospital.

Results:  50 patients were included in the study. Median age at presentation was 10.2 years old (range 0.7 – 18.0 years old). The most common presenting features were headache (74%), vision loss (32%), and nausea/vomiting (30%). At presentation, 42% had optic nerve pallor and 42% had optic nerve edema. Median follow-up was 4.5 years. During follow-up, 67% of patients had a recurrence requiring treatment and 32% of patients had at least one episode of sudden visual decline. At last follow-up, 60% of patients had moderate visual impairment in at least one eye (<20/40 or more than 50% visual field loss), 28% had moderate binocular visual impairment, and 12% of patients had severe binocular visual impairment (<20/200 or less than 20 degrees of visual field in the better eye).

Discussion:  Vision loss is a common presenting symptom of craniopharyngiomas in children, and key diagnostic findings include optic nerve pallor and edema.  After diagnosis, monitoring vision is important as sudden visual decline is a common indicator of recurrence. Vision loss occurs in the majority of patients, but severe binocular visual impairment is uncommon.

Conclusion:  Craniopharyngioma is a potentially blinding disease in children. Visual symptoms and ophthalmological exam findings are important in the diagnosis, prognosis, and monitoring of affected children.

References:  1. Sorva R, Heiskanen O, Perheentupa J. Craniopharyngioma surgery in children: endocrine and visual outcome. Childs Nerv Syst 1988;4(2):97-9.

2. Abrams LS, Repka MX. Visual outcome of craniopharyngioma in children. J Pediatr Ophthalmol Strabismus 1997;34(4):223-8.

3. Poretti A, Grotzer MA, Ribi K, Schonle E, Boltshauser E. Outcome of craniopharyngioma in children: long-term complications and quality of life. Dev Med Child Neurol 2004;46(4):220-9.

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