Postoperative visual field outcome measured by perimetry in sellar and parasellar tumors

Abstract

Background Compressive optic neuropathy at chiasm may lead to different degrees of visual acuity affection, color vision loss, and visual field (VF) changes in both eyes. Objective This study evaluates the predictive value of VF outcome 3 months after treatment of chiasmal and parachiasmal tumor compressing the anterior visual pathways. Methods Fifteen patients (eight women and seven men) were included in this study; their ages ranged from 30 to 57 years. All patients were operated upon at the Kasr El-Aini Neurosurgical Department. All of them underwent an evaluation of their history, a clinical examination, standard automated perimetry, evaluation of their hormonal profile, and radiological investigations. Ten patients were operated upon by means of the microscopic-assisted endoscopic endonasal trans-sphenoidal approach, and the remaining five patients were operated upon transcranially. Results Best-corrected visual acuity showed significant improvement from 0.464 ± 0.367 to 0.16 ± 0.17 LogMAR ( P = 0.009) in all patients after surgery. Mean deviation showed improvement in all patients, which was not statistically significant, from −11.289 ± 9.952 dB before surgery to −8.578 ± 7.651 dB at 3 months after surgery ( P = 0.330). As regards temporal VF sensitivity, group 1 showed significant improvement in temporal field sensitivity, from 88.054 to 237.967 1/Lambert (l/L), whereas group 2 showed significant worsening in temporal sensitivity, from 198.272 to 100.764 (l/L), and group 3 showed improvement in temporal sensitivity from 702.97 to 820.568 (l/L). Conclusion In this series, temporal field sensitivity was the best prognostic factor for determining the VF outcome in decompression surgery for sellar and parasellar tumors.