Visual Outcomes in Surgically Treated Intracranial Meningiomas

Area of Science:

• Neurosurgery
• Ophthalmology
• Oncology

Background:

• Medial sphenoid ridge meningiomas can compress optic nerves and chiasm, leading to vision impairment.
• Previous studies on visual outcomes after surgery often lack comprehensive and patient-validated data.

Purpose of the Study:

• To evaluate visual outcomes and impact on activities of daily living (ADL) after surgery for intracranial meningiomas.
• To identify predictors of visual outcomes in patients with these tumors.

Main Methods:

• Retrospective analysis of 40 patients with medial sphenoid ridge meningiomas.
• Assessment of visual outcomes using a novel method correlating with ADL, including patient self-reports via telephone interviews.
• Evaluation of ophthalmic, imaging, and surgical factors as predictors of outcome.

Main Results:

• 61% of patients with monocular visual dysfunction improved visually, but only 22% reported improved ADL; 17% lost vision.
• 73% of patients with binocular visual dysfunction improved visually with no vision loss in the better eye, yet only 27% reported improved ADL.
• Tumor characteristics like duration of impairment, optic disc pallor, size, and optic canal involvement did not predict visual outcomes.

Conclusions:

• Surgery frequently improves vision for sphenoid ridge meningiomas, especially with binocular dysfunction, but the effect on ADL is less pronounced.
• A significant portion of patients with monocular dysfunction experienced vision loss, suggesting surgery may be primarily for tumor management and risk mitigation.
• Ophthalmic and imaging features are poor predictors of visual outcomes; aggressive tumor debulking is not necessary for favorable results.