Objective: The aim of this study was to investigate the significance of the initial visual field as a predictor of recurrence of craniopharyngioma and postoperative visual outcome in children with craniopharyngioma.

Methods: A retrospective analysis was performed on 27 children 15 years of age or younger with craniopharyngioma. Records of clinical features including ocular and systemic symptoms, optic disc findings, and size of the tumor were analyzed according to preoperative visual field. Postoperative visual acuities, visual fields, and recurrence rates were also evaluated.

Results: Preoperatively, 13 patients had a normal visual field and 14 patients had various visual field defects. The size of the tumor was not correlated with the preoperative visual field defects (P = .15). Preoperative visual field defects were associated with polyuria and polydipsia (P = .01), higher recurrence (P < .001), and poorer postoperative visual acuities (P < .001).

Conclusions: Preoperative visual field can be a reliable clinical indicator of systemic manifestations, recurrence, and postoperative visual outcome in children with craniopharyngioma.