Optical Coherence Tomography in a Child for Detection of Bitemporal Hemianopia Due to Craniopharyngioma

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  • Goto Katsutoshi
    Department of Ophthalmology 1, Kawasaki Medical School
  • Miki Atsushi
    Department of Ophthalmology 1, Kawasaki Medical School Department of Orthoptics, Faculty of Rehabilitation, Kawasaki University of Medical Welfare
  • Araki Syunsuke
    Department of Ophthalmology 1, Kawasaki Medical School
  • Goto Yoshimi
    Department of Rehabilitation Center, Kawasaki Medical School Hospital
  • Mizukawa Kenichi
    Department of Ophthalmology 1, Kawasaki Medical School Shirai Eye Hospital
  • Kiryu Junichi
    Department of Ophthalmology 1, Kawasaki Medical School
  • Uno Masaaki
    Department of Neurosurgery 1, Kawasaki Medical School

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  • 頭蓋咽頭腫に高次脳機能障害を合併し，両耳側半盲の予測に光干渉断層計が 有用であった小児の1例

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Abstract

<p>　We present the case of a child who underwent optical coherence tomography to predict the presence of bitemporal hemianopia due to craniopharyngioma. A 3-year-old boy was seen by an ophthalmologist for decreased visual acuity and low activity and was referred to us on suspicion of tumorous lesion after inspecting head imaging. Visual acuity was light sense in both eyes, and there was no pursuit eye movement following the fixation target. The anterior segment and optic media were normal, but the fundus could not be evaluated because of eyelid closure. Magnetic resonance imaging revealed a cystic lesion in the sellar region. We diagnosed the patient as having craniopharyngioma. Chiasmal compression was released by bilateral frontal craniotomy and tumorectomy. We regularly tried to examine the visual field, but it was difficult to inspect exactly because of attention, hyperactivity, and concentration problems. Inner retinal layer analysis using OCT 2 years after surgery showed thinning of both nasal regions, suggesting bitemporal hemianopia. However, detection of bitemporal hemianopia using a visual field test was only achieved 5 years postoperatively. Inner retinal layer analysis using OCT is useful in the prediction of bitemporal hemianopia due to chiasmal compression in children with higher brain dysfunction in whom visual field testing is impossible.</p>

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