Prognostic factors for postoperative visual outcome in surgically treated suprasellar meningiomas

Abstract

The prognosis of postoperative visual acuity in patients with surgically treated suprasellar meningiomas is influenced not only by the size and precise localization of meningiomas in the optochiasmatic region and their compressive effect, but also by certain parameters, such as the age of patient, duration of symptoms, and preoperative visual acuity. The purpose of this study was to analyze the influence of these factors on postoperative visual acuity in the patients with surgically treated optochiasmatic meningioma as well as to determine their prognostic value in the recovery of visual function after surgery. The study sample consisted of 43 pati- ents operated for suprasellar meningioma. All tumors were dia- gnosed by computed tomography or nuclear magnetic resonance scans. Visual acuity was analyzed both before surgery and six months after surgery. The effects of age, preoperative Visual loss, duration of visual symptoms and tumor size on visual outcome were analyzed. Postoperative improvement of visual acuity was observed in 50% of eyes (68.4% of patients). Visual outcome was better in the younger patients. The patients with better preoperative visual acuity had better postoperative visual acuity outcome. Chances of achieving better postoperative visual function and favorable tumor resection outcome were inversely proportional to the increased length of history of disease and tumor size. Postoperative visual acuity prognosis in suprasellar meningioma surgery was favorably affected by the mean duration of symptoms of less than 24 months, tumor size less than 30 mm. and preoperative visual acuity loss below 0.1.