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Retinal NFL thinning on OCT correlates with visual field loss in pediatric craniopharyngioma
- Source :
- Canadian Journal of Ophthalmology. 48:494-499
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Objective To investigate the use of peripapillary optical coherence tomography for monitoring optic neuropathy in pediatric craniopharyngioma. Design Retrospective, consecutive-cohort, single-centre chart analysis. Participants Twenty children with craniopharyngioma treated at a pediatric medical centre from 1999 to 2011. Methods The medical files were reviewed for demographics and optic nerve function. Findings for visual acuity and visual fields were analyzed against repeated optical coherence tomography (OCT) measurements of peripapillary nerve fibre layer thickness (using either time-domain Stratus OCT or spectral-domain Cirrus OCT). Results Average age at diagnosis was 6.5 ± 3.88 years. The most common presenting symptom was headache; only 1 child complained of visual loss. Mean best corrected visual acuity (logMAR) was 0.036 ± 0.06 in the 17 healthy eyes and 1.05 ± 1.45 in the 23 eyes with optic neuropathy. Positive signs included relative afferent pupillary defect (8/20), visual acuity loss (7/20), temporal visual field loss (bilateral 4/15, unilateral 4/15), papilledema (3/20), and unilateral/bilateral optic disc pallor (14/20). RNFL thickness was significantly lower in eyes with optic neuropathy than in healthy eyes (65 ± 22 µm vs 86.2 ± 29 µm; p = 0.000) and correlated with visual acuity (r = –0.43 to –0.17, p = 0.0001) and presence or absence of a visual field defect (mean difference, 26.1 ± 5.8 µm, p = 0.003). Ten children showed no change in RNFL thickness over time (mean 18 ± 14.2 months). Conclusions A thinner RNFL on ocular coherence tomography is correlated with poorer visual acuity and visual field loss. Ocular coherence tomography may serve as an objective method to quantify axonal loss caused by craniopharyngioma. Further investigation is needed to determine its use for evaluating progressive axonal loss over time.
- Subjects :
- Male
Retinal Ganglion Cells
medicine.medical_specialty
Visual acuity
genetic structures
Visual Acuity
Axonal loss
Cohort Studies
Optic neuropathy
Craniopharyngioma
Nerve Fibers
Optical coherence tomography
Ophthalmology
Optic Nerve Diseases
Humans
Medicine
Pituitary Neoplasms
Child
Scotoma
Papilledema
Retrospective Studies
medicine.diagnostic_test
business.industry
Optic disc pallor
General Medicine
medicine.disease
eye diseases
Visual field
Visual Field Tests
Female
sense organs
Visual Fields
medicine.symptom
business
Tomography, Optical Coherence
Subjects
Details
- ISSN :
- 00084182
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- Canadian Journal of Ophthalmology
- Accession number :
- edsair.doi.dedup.....7802ea31330c833b5f385b8defd7179f
- Full Text :
- https://doi.org/10.1016/j.jcjo.2013.05.001