Visual Outcome Following Surgical Resection of Tuberculum Sellae Meningiomas

Background: Tuberculum sellae meningiomas represent about 3-10% of intracranial meningiomas. Unilateral visual affection is the initial and most common symptom. Objective: Assessment of visual outcome following resection of tuberculum sellae meningiomas and its correlation with the duration and severity of preoperative visual affection. Patients and Methods: The study included eighteen patients with tuberculum sellae meningiomas operated upon between August 2010 and August 2015. Patients were divided into two groups according to the time of decompression performed whether within one year or after one year from the beginning of visual symptoms. The degree of preoperative visual affection was considered severe if visual acuity was less than or equal to 1/60 or partial if more than 1/60. Visual outcome was assessed in the early postoperative period and on regular intervals. Results: Gross total resection was achieved in 77.8% of patients. Visual improvement occurred in 43.8% of patients being 54.5% in patients with visual affection less than one year and 20% in patitients with visual affection more than one year. Visual preservation was achieved in all eyes with partial visual affection and in 84.2% of the eyes with severe affection. There were two mortalities in this study due to perforator injuries. Conclusion: The duration of preoperative symptoms has a strong influence on visual outcome. Visual preservation is related to the degree of severity of visual affection preoperatively. Thus early diagnosis is required for a better chance of successful treatment with good postoperative visual outcome.