Choroidal microcirculation in pediatric craniopharyngioma: postoperative alterations in choroidal thickness

To evaluate choroidal microcirculation using choroidal thickness (CTh) in pediatric patients with surgically treated adamantinomatous craniopharyngioma (CP) and to identify clinical and tumor-related factors associated with CTh.

This cross-sectional, prospective, observational study included 60 eyes of 31 children with histopathologically confirmed CP and 78 eyes of 39 age- and sex-matched healthy controls. Comprehensive ophthalmological examination and spectral-domain optical coherence tomography (SD-OCT) were performed in all participants. CTh was manually measured at five locations: subfoveal (SFCTh), 1500 μm superior, inferior, nasal, and temporal to the fovea in both eyes. Tumor characteristics and demographic data were collected and analyzed for associations with CTh.

CTh was significantly thinner in the CP group compared to controls at all locations except 1500 μm superior to the fovea. The mean subfoveal CTh was 333.13 μm in the CP group and 370.13 μm in the control group (p < 0.05). The most pronounced thinning was observed nasally (255.93 vs. 335.06 μm, p < 0.05). At the temporal location, mean CTh was 317.62 μm in the CP group and 360.62 μm in controls (p < 0.05). Inferiorly, it measured 318.88 μm in the CP group vs. 346.04 μm in controls (p < 0.05). Superior CTh was 340.23 μm in the CP group and 358.47 μm in controls, with no statistically significant difference (p = 0.08). In the study group, the thickest CTh was found superiorly, while in the control group, it was SFCTh. In both groups, the thinnest CTh was observed nasally. Children born in the city had a significantly thicker SFCTh than those born outside the city (p < 0.005). Cavernous sinus infiltration was associated with increased nasal CTh and temporal CTh (p < 0.005). No association was found between CTh and tumor location, tumor volume, tumor diameter, morphology, third ventricle invasion, hydrocephalus, Rosenthal fibers or ventriculoperitoneal shunt. Age at examination and gender did not affect CTh.

Pediatric patients with CP show significantly reduced CTh in multiple locations. Place of birth, and specific tumor characteristics such as cavernous sinus infiltration were influenced by CTh. These findings highlight the complex interplay between tumor characteristics and ocular microvascular changes in pediatric patients with CP.