Clinical Outcomes of Tuberculum Sellae Meningiomas Focusing on Reversibility of Postoperative Visual Function

Objective: The aim of this study was to determine the prognostic determinants of clinical and visual outcomes of these tumors, focusing on the functional reversibility of an unserviceable eye after surgery. Study Design: Retrospective analysis. Patients/material and Methods: We reviewed 86 patients. The visual acuity and visual fields were analyzed. Unserviceable visual acuity included no perception of light (NPL), hand movement (HM), and counting fingers (CF). Ophthalmological functioning was tested in the preoperative period, the postoperative short-term period, and the postoperative long-term period (>6 months after surgery). Our own clinical outcome criteria including tumor control, visual improvement, and complications were used. Results: Overall 74 of 86 patients underwent total removal of the tumor. In multivariate analysis, adhesion to optic nerve was an independent predictor of clinical outcome. Favorable visual outcomes in both short-term and long-term postoperative periods were achieved in 80.8%. Six of eight patients with preoperative CF status showed reversibility to a serviceable status after surgery. However, there was no conversion to serviceable status from NPL or HM. Conclusions: For patients with unilateral unserviceable visual function, maintenance of serviceable visual function on the opposite side might be more important. Of the patients with unserviceable visual function, careful surgery might be able to improve the visual function in CF eyes.