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Visual Outcomes after Suprasellar Meningioma Resection: A Retrospective Cohort Study and a Machine Learning-Based

Arad Iranmehr¹, Mohammadreza Chavoshi², Mehdi Zeinalizadeh¹

¹Department of Neurosurgery, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex (IKHC), Tehran, Iran.

Journal of Neurological Surgery. Part B, Skull Base

|January 30, 2025

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Predictors of visual outcome after suprasellar meningioma surgery were identified. Intracanous sinus extension impacts recurrence, while early optic canal decompression did not improve visual outcomes.

Area of Science:

Neurosurgery
Ophthalmology
Oncology

Background:

Suprasellar meningiomas can impact visual function due to their proximity to optic pathways.
Predicting visual outcomes after surgical resection is crucial for patient management.

Purpose of the Study:

To identify predictors of visual outcome following surgery for suprasellar meningiomas.
To evaluate the efficacy of early intradural optic canal decompression (IOCD) on visual recovery.
To develop a machine learning model for predicting visual recovery.

Main Methods:

Retrospective cohort study of 82 patients with suprasellar meningiomas.
Matched case-control analysis comparing early IOCD versus no early IOCD.
Development of a machine learning model for visual recovery prediction.

Keywords:

meningioma optic canal decompression suprasellar visual outcome

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Main Results:

Visual acuity score (VAS) improved in 46.3%, decreased in 7.4%, and remained unchanged in 46.3% postoperatively.
Preoperative visual complaints, optic atrophy, tuberculum sella, and olfactory groove involvement correlated with lower preoperative VAS and visual field index (VFI).
Intracavernous sinus (ICS) extension and intraoperative vascular involvement were linked to poorer postoperative VAS correction. Early IOCD showed no significant difference in VAS or VFI improvement.

Conclusions:

ICS extension is associated with increased tumor recurrence, suggesting a role for postoperative radiotherapy.
Early IOCD is not supported as an effective method for improving postoperative visual acuity or visual field index.