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Predictive Factors for Postoperative Visual Recovery in Surgically Treated Suprasellar Meningioma: A Retrospective Analysis

Background: Post-operative visual outcome in surgically treated suprasellar meningiomas is a great concern for surgeon, patient and of course for the health system. Certain reports were published before questioning about the aim of treating such tumors in which visual recovery cannot be guaranteed. It is important to classify the possible factors that may predict the prognosis thereafter. Aim of Study: Assessment of the visual function perioperatively and to delineate the factors of visual recovery in surgically treated suprasellar meningioma. Patients and Methods: This was a retrospective analysis of 24 patients who were operated for suprasellar meningioma in Kasr Al-Ainy University Hospital from January 2018 to July 2020. The following predictive factors were tested: Age, duration of symptoms, pre-operative visual function damage, and radiological criteria of the tumor. Results: An overall improvement in visual function was seen in 14/24 patients (58.3%) in our study. The mean and standard deviation of symptoms' duration in months were 12.36±5.11 (3-23 months). Gross total resection was achieved in 19 cases (79.1%). Gross total resection achieved improvement of overall visual function in 73.7% of cases with statistically significant difference versus subtotal resection ( p-value =0.03). It has been found that duration of symptoms (less than 12 months), mild pre-operative visual symptoms, tumor size less than 3cm, absence of optic nerve extension and gross total resection are related to post-operative improvement in visual outcome. Conclusion: Visual recovery of surgically treated suprasellar meningiomas is greatly dependent on duration of symptoms, pre-operative visual status, tumor size, adherence to strategic neurovascular structures and gross total resection.