AUTHOR=Zhang Qing Lin , Wang Jun Hua , Sun Li Ying , Wang Jian Bin , Ma Yu , Zhang Yu Qi 

TITLE=Optical Coherence Tomography Angiography Predicts Visual Outcomes for Craniopharyngioma in Children by Quantifying Choroidal Capillaries

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.819662

DOI=10.3389/fmed.2021.819662

ISSN=2296-858X

ABSTRACT=<p><bold>Purpose:</bold> To predict the prognosis of craniopharyngioma in children by optical coherence tomography angiography (OCTA).</p><p><bold>Methods:</bold> We evaluated if the relationship between preoperative OCTA of the choroidal capillary density (CCD) and visual outcome continued over long-term visual recovery in 38 patients undergoing craniopharyngioma resection. Patients were evaluated 3 times: 1 week before surgery (Visit1), followed-up at 6–10 weeks (Visit2), and 9–15 months (Visit3) after surgery.</p><p><bold>Results:</bold> In total 38 patients (70 eyes) with craniopharyngiomas, which included 20 (52.6%) boys and 18 (47.4%)girls, the mean age was 11.8 ± 2.7 years (range: 6–18 years). The age (<italic>p</italic> = 0.71), gender (<italic>p</italic> = 1.00), mean refractive error (<italic>p</italic> = 0.55), and axial length (<italic>p</italic> = 0.23) of 38 normal volunteers (76 eyes) were matched. After surgery, the cross-compression of patients was relieved. The average visual acuity change in the normal CCD group was 0.07 ± 0.02; the average visual acuity change in the low CCD group was 0.01 ± 0.01, <italic>p</italic> &lt; 0.001. Preoperative CCD value is related to the preoperative BCVA (<italic>p</italic> &lt; 0.001), and the visual function after the long-term follow-up (9–15 months) (<italic>p</italic> &lt; 0.001). The prognosis of CCD has the same trend as the BCVA. Further correlation analysis shows that CCD and BCVA are significantly correlated (<italic>r</italic> = 0.878; <italic>p</italic> &lt; 0.001). CCD has a weak but significant correlation both with MD (<italic>r</italic> = 0.19; <italic>p</italic> &lt; 0.001) and PSD (<italic>r</italic> = −0.21; <italic>p</italic> &lt;0.001). A natural cutoff of CCD is approximately 38%. With the normal CCD group the maximum improvement of BCVA exceeds 0.3 post-operatively, compared to eyes in the low CCD group that improve by &lt;0.03, and worse after surgery.</p><p><bold>Conclusions:</bold> Long-term vision recovery after surgical decompression of craniopharyngiomas in children can be predicted by preoperative by OCTA. Patients with normal CCD before surgery showed a tendency to improve vision; this trend of improvement persisted in subsequent follow-ups. The CCD baseline natural cutoff value for predicting visual prognosis before and after surgery is about 38%.</p>