CR-18A REVIEW OF VISUAL OUTCOMES IN CHILDHOOD CRANIOPHARYNGIOMA TREATED WITH A HYPOTHALAMIC SPARING, SURGICAL AND RADIATION STRATEGY

Abstract

CR-18. A REVIEW OF VISUAL OUTCOMES IN CHILDHOOD CRANIOPHARYNGIOMA TREATED WITH A HYPOTHALAMIC SPARING, SURGICAL AND RADIATION STRATEGY Victoria Smith1, Bronwen Walters1, Alki Liasis1, Kristian Acquilina1, Helen Spoudeas1, Katrina Prise1, Christos Moraitis1, and Richard Bowman1,2; Great Ormond Street Hospital, London, UK; UCL Institute of Child Health, London, UK AIM: To review visual outcomes in childhood craniopharyngioma. METHOD: Retrospective longitudinal case review. RESULTS: 27 (19M) patients diagnosed at mean age 88 months and followed for 26 months. VISUAL ACUITY: At first assessment 2 patients were classified as blind, (light perception & 1.325) and one having low vision (limited following) employing the WHO classification (binocular vision). Post-intervention one patient remained blind (no light perception) and 2 had low vision (1.10, 0.60). A further 6 patients had monocular vision loss (worse than 1.30) at presentation versus 7 post-intervention. Older children tended to have better visual acuity pre and post treatment (p 1⁄4 0.05). 20 (74%) patients retained final binocular vision of 0.20 LogMAR or better. VISUAL FIELDS: 9 children underwent Goldmann kinetic perimetry in at least one eye (17 eyes) graded by Wall and George classification. At diagnosis 6 (36%) eyes had minimal or mild loss, 9 eyes (53%) had moderate loss and 2 eyes (11%) had marked loss. Post-intervention 3 (17%) eyes showed no visual field loss, 6 (36%) eyes had minimal or mild loss and 8 (47%) eyes showed moderate loss. Grades improved/ were stable in 15 eyes (89%) and deteriorated in 2 (11%). OPTIC ATROPHY: Optic disc pallor was similar between first and last visit, 56% versus 50%. CONCLUSIONS: Although visual field loss and optic pallor are common most children retain good vision in at least one eye and where formal testing was possible, field deficits improved/ stabilised in most eyes (15/17). Neuro-Oncology 18:iii18–iii23, 2016. doi:10.1093/neuonc/now068.18 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.