TY - JOUR

T1 - Predictors of visual outcome in patients operated for craniopharyngioma - a Danish national study

AU - Jacobsen, Mads Forslund

AU - Thomsen, Ann Sofia Skou

AU - Bach-Holm, Daniella

AU - Doroudian, Ghazaleh

AU - Nissen, Kamilla Rothe

AU - Fugleholm, Kare

AU - Poulsgaard, Lars

AU - Siersma, Volkert

AU - Heegaard, Steffen

PY - 2018/2

Y1 - 2018/2

N2 - PurposeCraniopharyngioma often causes visual loss due to the close relation to the anterior visual pathways. This study investigates the incidence and predictors of visual outcomes in patients with craniopharyngioma.MethodsData from sixty-six patients who underwent surgery for craniopharyngioma from 2009 to 2013 in Denmark were reviewed. Primary outcomes were visual acuity (VA) and visual field (VF) defects from pre-and postoperative visits. Secondary outcomes were optic nerve atrophy (OA) and papilledema.ResultsFifty-eight patients were included. The VA of the patients 1-year after surgery improved by −0.16 log(MAR) (95%CI: −0.30 to −0.02; p = 0.0266). Visual field (VF) defects worsened in 17 eyes (30%), remained stable in 21 eyes (37%) and improved in 19 eyes (33%). The presence of papilledema and the absence of OA were significantly correlated with an improvement in VA postoperatively (p = 0.011 and p = 0.011, respectively). Patients undergoing surgery within a week or less after their first ophthalmological examination had a significant improvement in VA (−0.36; 95%CI: −0.62 to −0.09; p = 0.0099). Patients undergoing surgery using a subfrontal approach also showed improvement in VA (p = 0.048). Tumour recurrence had a significantly worse VA outcome (p = 0.0074).ConclusionPatients show a slight improvement in VA 1-year after operation for craniopharyngioma. The presence of papilledema and early surgical intervention is associated with a significant improvement in VA. Early involvement of a dedicated ophthalmologist is recommended to secure an early detection of a visual decline and potential tumour recurrence.

AB - PurposeCraniopharyngioma often causes visual loss due to the close relation to the anterior visual pathways. This study investigates the incidence and predictors of visual outcomes in patients with craniopharyngioma.MethodsData from sixty-six patients who underwent surgery for craniopharyngioma from 2009 to 2013 in Denmark were reviewed. Primary outcomes were visual acuity (VA) and visual field (VF) defects from pre-and postoperative visits. Secondary outcomes were optic nerve atrophy (OA) and papilledema.ResultsFifty-eight patients were included. The VA of the patients 1-year after surgery improved by −0.16 log(MAR) (95%CI: −0.30 to −0.02; p = 0.0266). Visual field (VF) defects worsened in 17 eyes (30%), remained stable in 21 eyes (37%) and improved in 19 eyes (33%). The presence of papilledema and the absence of OA were significantly correlated with an improvement in VA postoperatively (p = 0.011 and p = 0.011, respectively). Patients undergoing surgery within a week or less after their first ophthalmological examination had a significant improvement in VA (−0.36; 95%CI: −0.62 to −0.09; p = 0.0099). Patients undergoing surgery using a subfrontal approach also showed improvement in VA (p = 0.048). Tumour recurrence had a significantly worse VA outcome (p = 0.0074).ConclusionPatients show a slight improvement in VA 1-year after operation for craniopharyngioma. The presence of papilledema and early surgical intervention is associated with a significant improvement in VA. Early involvement of a dedicated ophthalmologist is recommended to secure an early detection of a visual decline and potential tumour recurrence.

KW - craniopharyngioma

KW - visual acuity

KW - visual field

KW - visual outcome

U2 - 10.1111/aos.13483

DO - 10.1111/aos.13483

M3 - Journal article

C2 - 28661562

VL - 96

SP - 39

EP - 45

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

SN - 1755-375X

IS - 1

ER -