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Visual outcome after surgery for cavernous sinus meningioma
1Consultation de Neuro-Opthalmologie, Hôpital Neurologique et Neurochirugical Pierre Wertheimer, Lyon, France. maudjacob@gmail.com
Acta Neurochirurgica
|April 19, 2008
Summary
Surgery for cavernous sinus meningiomas can preserve vision in one eye for most patients, but outcomes for the affected eye are unpredictable. Optic disc pallor indicates a poor prognosis for vision after surgery.
Area of Science:
- Neurosurgery
- Ophthalmology
- Oncology
Background:
- Cavernous sinus meningiomas (CSMs) extending beyond the sinus can compress optic nerves and chiasm, risking vision loss.
- Surgical resection aims to preserve long-term vision but carries risks to anterior visual pathways.
Observation:
- This retrospective study analyzed 30 patients with unilateral CSMs and extra-cavernous extension undergoing surgery.
- Visual status was assessed pre- and post-operatively, with a mean follow-up of 2 years, excluding radiotherapy.
Findings:
- 50% of patients experienced worsening vision in the ipsilateral eye, while 23% improved. Optic disc pallor was a poor prognostic indicator.
- 93% of patients maintained good vision in at least one eye post-surgery; 40% had good vision in both eyes.
- Contralateral eyes showed good outcomes, with 57% improving when affected pre-operatively.
Implications:
- Conservative surgery for CSMs rarely causes significant visual handicap.
- Surgical decompression can protect contralateral visual pathways, potentially preserving long-term vision.
- While ipsilateral visual outcomes are unpredictable, surgery offers a chance for vision preservation in at least one eye.