Features of neuro-ophthalmic symptoms in patients with parasellar meningiomas

Abstract

Goal. To analyze the features of neuro-ophthalmic symptoms and study visual functions recovery following parasellar meningiomas (PM) surgery. Material and methods. We have analyzed the results of treating 47 patients with PM which have been operated in the Romodanov Neurosurgery Institute in 2017 - 2021. The main group included 47 patients (94 eyes) with PM with visual disorders. Clinical-neurological and ophthalmological examination and a range of neuroimaging studies were carried out. To evaluate the visual functions, the results were analyzed according to the recommendations of the German Ophthalmological Society. Results. Binocular visual disturbances have been detected in 34 (72.3%) patients. Among visual field defects, absolute bitemporal hemianopia prevailed in 14.9% of patients and a combination of relative upper quadrant temporal hemianopia with absolute temporal hemianopia in 19.2% of patients. Monocular visual disturbances have been detected in 13 (27.7%) patients. Optic nerve atrophy was found in 38 patients (80.9%): unilateral - 21 patients (21 eyes), bilateral - 17 patients (34 eyes). A probable difference was revealed in the average visual acuity: before treatment 0.55±0.04, after treatment 0.67±0.04 (p<0.05) and the average total loss of sensitivity: before treatment 11.37±0, 78 dB and after treatment 9.14±0.79 dB (p<0.05). Conclusions. Parasellar meningiomas constitute a significant part of extracerebral tumors. As a result of surgical treatment, there is a significant improvement in visual acuity and visual field.