Shinohara Yoichiro, Yamada Chizu, Yamaguchi Rei, Tosaka Masahiko, Oya Soichi, Akiyama Hideo
Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa machi, Maebashi, Gunma, 371-8511, Japan.
Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, 371-8511, Japan.
Jpn J Ophthalmol. 2025 Aug 20. doi: 10.1007/s10384-025-01267-3.
To investigate the relationship between visual function, optical coherence tomography (OCT) parameters, and optic nerve bending before and after tumor resection in adult patients with craniopharyngioma.
Retrospective observational study.
We retrospectively evaluated 22 eyes of 11 adult patients with craniopharyngioma who underwent tumor resection surgery. We assessed the preoperative and 1-month postoperative best-corrected visual acuity (BCVA), simple visual field impairment score (SVFIS) for visual field evaluation, 6-segmented macular ganglion cell layer (GCL) + inner plexiform layer (IPL) and 4-segmented circumpapillary retinal nerve fiber layer (cpRNFL) thickness, and optic nerve-canal bending angle (ONCBA).
Bilateral hemianopia was observed in 10 patients (91%), whilst homonymous hemianopia was observed in 1 patient (9%). The BCVA and SVFIS scores improved significantly postoperatively (both P <.001), and eyes with optic nerve bending had significantly worse preoperative BCVA and SVFIS (both P <.001), and the ONCBA was significantly correlated with preoperative BCVA, SVFIS, and GCL+IPL thickness in all areas. OCT detected superior nasal GCL+IPL thinning in 10 eyes (45%) and superior cpRNFL thinning in 2 eyes (9%).
In adult patients with craniopharyngioma, GCL+IPL and cpRNFL thicknesses were associated with postoperative visual function recovery. The ONCBA was associated with preoperative visual dysfunction. ONCBA, GCL+IPL, and RNFL thicknesses may be useful for monitoring visual function in adult craniopharyngiomas preoperatively and postoperatively.
探讨成年颅咽管瘤患者肿瘤切除前后视觉功能、光学相干断层扫描(OCT)参数与视神经弯曲之间的关系。
回顾性观察研究。
我们回顾性评估了11例接受肿瘤切除手术的成年颅咽管瘤患者的22只眼睛。我们评估了术前和术后1个月的最佳矫正视力(BCVA)、用于视野评估的简单视野损害评分(SVFIS)、6段黄斑神经节细胞层(GCL)+内丛状层(IPL)以及4段视盘周围视网膜神经纤维层(cpRNFL)厚度,以及视神经-管弯曲角度(ONCBA)。
10例患者(91%)出现双侧偏盲,1例患者(9%)出现同向偏盲。术后BCVA和SVFIS评分显著改善(均P<.001),视神经弯曲的眼睛术前BCVA和SVFIS明显更差(均P<.001),并且ONCBA与所有区域的术前BCVA、SVFIS和GCL+IPL厚度显著相关。OCT检测到10只眼睛(45%)鼻上象限GCL+IPL变薄,2只眼睛(9%)视盘上方cpRNFL变薄。
在成年颅咽管瘤患者中,GCL+IPL和cpRNFL厚度与术后视觉功能恢复相关。ONCBA与术前视觉功能障碍相关。ONCBA、GCL+IPL和RNFL厚度可能有助于术前和术后监测成年颅咽管瘤患者的视觉功能。