Visual outcome in surgically treated suprasellar meningiomas

Area of Science:

• Neurosurgery
• Ophthalmology
• Oncology

Background:

• Suprasellar meningiomas are tumors located above the optic chiasm.
• These tumors can cause significant visual impairment due to their proximity to critical visual pathways.
• Long-term visual outcomes after surgical treatment are not well-established.

Purpose of the Study:

• To determine the long-term visual outcomes (>10 years) in patients treated surgically for suprasellar meningiomas.
• To assess the rate and timing of tumor recurrence after surgery.
• To identify factors influencing visual prognosis and recurrence.

Main Methods:

• Retrospective case series analysis of 18 patients who underwent surgery for suprasellar meningioma.
• Review of long-term follow-up data, including visual acuity and neuroimaging.
• Correlation of visual outcomes with tumor recurrence and treatment modalities.

Main Results:

• No patient experienced postoperative worsening of vision in both eyes.
• Over 10 years, 56% maintained stable vision in both eyes; 33% lost vision in one eye; 11% lost vision in both eyes.
• Tumor recurrence or growth was observed in 39% of patients, often occurring >10 years post-surgery, even after presumed gross total resection.
• Vision worsening was associated with tumor recurrence, and subsequent treatments were often ineffective.

Conclusions:

• Long-term visual prognosis after suprasellar meningioma surgery is generally excellent.
• Tumor recurrence is a significant concern, necessitating long-term surveillance with clinical exams and neuroimaging.
• Postoperative radiation therapy is recommended for incompletely resected tumors to manage recurrence risk.