OBJECTIVE

The analyze the neuro-ophthalmic outcomes in patients with pineal and suprasellar germinoma after complex treatment.

MATERIAL AND METHODS

There were 125 patients (88 males, 37 females) with primary CNS germinoma for the period 2008—2017. All patients were divided into 3 groups depending on the tumor localization: pineal area — 62 patients, suprasellar neoplasm — 38 patients, bifocal germinoma — 25 patients. Treatment was performed in accordance with the «Germinoma-2008» protocol. Tumors were histologically patients (partial — 32 cases, subtotal — 16 cases). Surgery was followed by postoperative chemotherapy and stereotactic radiotherapy. The results were evaluated by neuro-ophthalmological examination at all stages of complex treatment.

RESULTS

Pineal germinoma resulted oculomotor and pupillary disorders (58 patients — 94%) and papilledema. The last one completely regressed under the treatment. Partial reduction of oculomotor and pupillary abnormalities occurred throughout chemotherapy (6 patients — 10%). More than half of patients (n=24, 63%) with suprasellar germinoma had visual impairment. Improvement of visual functions including severe visual disturbance was observed in 14 patients (58%). Predominantly, functional recovery occurred under chemotherapy (12 patients — 86%). Bifocal germinoma was followed by various combinations of oculomotor, pupillary and/or visual impairments. We observed regression of only mild visual disorders. Stereotactic radiotherapy did not ensure any changes in neuro-ophthalmic symptoms in all groups.