Visual functions in children with craniopharyngioma at diagnosis: A systematic review

Abstract

Childhood craniopharyngioma is a rare and slow growing brain tumour, often located in the sellar and suprasellar region. It commonly manifests with visual impairment, increased intracranial pressure and hypothalamic and/or pituitary deficiencies. Visual impairment in childhood adversely affects a child's daily functioning and quality of life. We systematically reviewed the literature to provide an extensive overview of the visual function in children with craniopharyngioma at diagnosis in order to estimate the diversity, magnitude and relevance of the problem of visual impairment. Of the 543 potentially relevant articles, 84 studies met our inclusion criteria. Visual impairment at diagnosis was reported in 1041 of 2071 children (50.3%), decreased visual acuity was reported in 546 of 1321 children (41.3%) and visual field defects were reported in 426 of 1111 children (38.3%). Other ophthalmological findings described were fundoscopic (32.5%) and orthoptic abnormalities (12.5%). Variations in ophthalmological testing methods and ophthalmological definitions precluded a meta-analysis. The results of this review confirm the importance of ophthalmological examination in children with craniopharyngioma at diagnosis in order to detect visual impairment and provide adequate support. Future studies should focus on long-term visual follow-up of childhood craniopharyngioma in response to different treatment strategies to provide insight in risks and ways to prevent further loss of vision.

Recurrent craniopharyngioma

“…4 However, the close relationship of the tumor with the anterior visual pathway produces variable campimetric alterations 2 in 68-84%. Repka et al 5 found that 17% of patients had vision of 20/40 or worse in the better eye at diagnosis and 27% continued to have the same or worse visual acuity in the better eye postoperatively. 6 For this reason, difficulties in seeing the blackboard at school or sitting closer to the television are also brought to the consultation.…”

Optical Coherence Tomography Angiography Predicts Visual Outcomes for Craniopharyngioma in Children by Quantifying Choroidal Capillaries

“…As the most common symptom in patients with craniopharyngioma, especially in children, the prognosis of visual function is always an important focus (12). In previous clinical practice, subjective examinations such as visual acuity and visual field were mostly used, which have a learning curve, but the need to repeat the measurement many times (13,14).…”

“…In addition, the above-mentioned examinations are difficult to operate, with long examination times and high coordination requirements. It is difficult for patients to complete the examination in the early postoperative period, especially for children ( 12 ).…”

Multidisciplinary Management of Craniopharyngiomas in Children: A Single Center Experience

“…In more than 50% of patients affected by CP, visual acuity and fields can deteriorate [ 60 ], causing difficulties in scholarly activities, daily life, and self-perception [ 61 ]. We found visual impairment in 70% of our patients at the time of diagnosis.…”