Purpose: The present study aims to evaluate alterations in the peripapillary retinal nerve fiber layer (RNFL) thickness in pediatric patients following surgical resection of childhood-onset craniopharyngioma (CP) and to identify tumor characteristics and other factors influencing these alterations, including changes in the lesion’s location. Design: retrospective clinical cohort study. Methods: A retrospective analysis was conducted on 73 eyes from 38 patients with CP and 64 eyes from 32 age- and sex-matched healthy controls. The mean age of the CP patients was 10.3 ± 4.2 years (range 4–17), while the control group had a mean age of 10.5 ± 3.1 years (range 4–17). Optical coherence tomography (OCT) was used to assess the peripapillary RNFL thickness in the study and control groups. RNFL thickness was analyzed in the superior, inferior, and average sectors, as well as across eight optic nerve sectors. Tumor characteristics were evaluated to determine their correlation with changes in RNFL thickness in individual sectors. Results: Postoperative thickness of peripapillary RNFL in all individual sectors was significantly reduced in the CP group compared to healthy controls. Location, tumor volume, maximum tumor diameter, calcification, ventriculoperitoneal shunt, surgery technique, total resection, presence of Rosenthal fibers, and reoperation due to progression or recurrence correlated with damage to RNFL. Conclusions: CP is associated with significant reductions in RNFL thickness, indicating the tumor’s impact on optic nerve fibers. OCT is a valuable tool for monitoring visual pathway impairment and postoperative outcomes. Correlations between RNFL thickness in individual sectors and clinical parameters may offer valuable insights for diagnosis and monitoring, underlining their potential role in predicting visual outcomes. Regular RNFL evaluation should be integrated into the long-term care of CP patients to optimize visual prognosis and detect progressive or residual damage.
目的：本研究旨在评估儿童期发病颅咽管瘤（CP）手术切除后患儿视盘周围视网膜神经纤维层（RNFL）厚度的变化，并识别影响这些变化的肿瘤特征及其他因素，包括病灶位置的变化。设计：回顾性临床队列研究。方法：对38例CP患者的73只眼及32例年龄和性别匹配的健康对照者的64只眼进行回顾性分析。CP患者平均年龄为10.3±4.2岁（范围4-17岁），对照组平均年龄为10.5±3.1岁（范围4-17岁）。使用光学相干断层扫描（OCT）评估研究组和对照组的视盘周围RNFL厚度。分析了上方、下方、平均象限以及八个视神经分区的RNFL厚度。评估肿瘤特征以确定其与各分区RNFL厚度变化的相关性。结果：与健康对照组相比，CP组术后所有分区的视盘周围RNFL厚度均显著降低。肿瘤位置、体积、最大直径、钙化、脑室腹腔分流术、手术技术、全切除、Rosenthal纤维的存在以及因进展或复发再次手术均与RNFL损伤相关。结论：CP与RNFL厚度显著降低相关，表明肿瘤对视神经纤维的影响。OCT是监测视觉通路损伤和术后结果的重要工具。各分区RNFL厚度与临床参数之间的相关性可能为诊断和监测提供有价值的见解，突显其在预测视力结局方面的潜在作用。应将定期RNFL评估纳入CP患者的长期护理中，以优化视力预后并检测进展性或残留性损伤。
肿瘤(癌症)患者之家