Drimtzias Evangelos, Falzon Kevin, Picton Susan, Jeeva Irfan, Guy Danielle, Nelson Olwyn, Simmons Ian
Department of Ophthalmology, Leeds Teaching Hospitals, St. James University Hospital, Beckett Street, Leeds, West Yorkshire, Ls9 7tf, UK,
J Neurooncol. 2014 Dec;120(3):651-6. doi: 10.1007/s11060-014-1600-5. Epub 2014 Aug 31.
We present our experience over the long-term of monitoring of visual function in children with craniopharyngioma. Our study involves an analysis of all paediatric patients with craniopharyngioma younger than 16 at the time of diagnosis and represents a series of predominantly sub-totally resected tumours. Visual data, of multiple modality, of the paediatric patients was collected. Twenty patients were surveyed. Poor prognostic indicators of the visual outcome and rate of recurrence were assessed. Severe visual loss and papilledema at the time of diagnosis were more common in children under the age of 6. In our study visual signs, tumour calcification and optic disc atrophy at presentation are predictors of poor visual outcome with the first two applying only in children younger than 6. In contrast with previous reports, preoperative visual field (VF) defects and type of surgery were not documented as prognostic indicators of poor postoperative visual acuity (VA) and VF. Contrary to previous reports calcification at diagnosis, type of surgery and preoperative VF defects were not found to be associated with tumour recurrence. Local recurrence is common. Younger age at presentation is associated with a tendency to recur. Magnetic resonance imaging (MRI) remains the recommended means of follow-up in patients with craniopharyngioma.
我们介绍了对颅咽管瘤患儿视觉功能进行长期监测的经验。我们的研究分析了所有诊断时年龄小于16岁的小儿颅咽管瘤患者，且主要为次全切除肿瘤的系列病例。收集了小儿患者多种形式的视觉数据。对20名患者进行了调查。评估了视觉预后的不良预测指标和复发率。诊断时严重视力丧失和视乳头水肿在6岁以下儿童中更为常见。在我们的研究中，视觉体征、肿瘤钙化和就诊时的视盘萎缩是视觉预后不良的预测指标，前两者仅适用于6岁以下儿童。与先前的报告相反，术前视野（VF）缺损和手术类型未被记录为术后视力（VA）和VF不良的预后指标。与先前的报告相反，诊断时的钙化、手术类型和术前VF缺损未被发现与肿瘤复发相关。局部复发很常见。就诊时年龄较小与复发倾向相关。磁共振成像（MRI）仍然是颅咽管瘤患者推荐的随访手段。
