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Craniopharyngioma: a review of long‐term visual outcome
Author(s) -
Chen Celia,
Okera Salim,
Davies Peter E,
Selva Dinesh,
Crompton John L
Publication year - 2003
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1046/j.1442-9071.2003.00648.x
Subject(s) - medicine , craniopharyngioma , visual acuity , visual field , presentation (obstetrics) , pediatrics , surgery , ophthalmology
Purpose: To assess the clinical presentation and long‐term visual outcome in a series of patients with craniopharyn‐gioma. Methods: Retrospective case review. Results: Thirty‐six patients were reviewed, comprising 19 female patients and 17 male patients. The age range was 2−77 years with a bimodal distribution of 17 children (mean age 10 years) and 19 adults (mean age 47 years). Blurred vision was the most common visual complaint (23 cases, 64%) and headache the most frequent systemic complaint (19 cases, 53%). The average duration of systemic symptoms was 45 weeks compared to 10 weeks for visual symptoms. Deficits in visual acuity occurred in 13 patients (36%) and showed no significant change from initial presentation to final review. Sixteen patients (44%) had bitemporal hemianopia on presentation and pleomorphism (change from one type of visual field defect to another) occurred in 11 patients. Recurrence of tumour occurred in 15 patients (42%) and was more likely in children (59%) than adults (26%). The mean time period to recurrence was 7 years. The average follow‐up period for all cases was 10 years. Conclusion: Patients with craniopharyngioma generally present late, and the visual symptoms are often preceded by a long history of systemic symptoms. Children are more likely to present with systemic symptoms than adults. Visual field pleomorphism is a feature of craniopharyngioma and occurred in one‐third of the patients. Local recurrence is common. Although magnetic resonance imaging is the recommended means of follow up, regular neuro‐ophthalmic review is useful in the early detection of anterior visual pathway compression by recurrent tumour.