Prognostic factors in the surgical treatment of intracanalicular primary optic nerve sheath meningiomas

Rassi, Marcio S.; Prasad, Sashank; Can, Anil; Almefty, Rami O.; Al‐Mefty, Ossama

doi:10.3171/2018.4.jns173080

Cited by 14 publications

(22 citation statements)

References 45 publications

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“…26 Rassi et al reported that patients with good preoperative vision and CSF flow in the optic sheath had better chances of a favorable outcome than those with poor vision. 27 In our series, ONSM was diagnosed on average 16 months after patients first noticed changes in their vision or reported symptoms related to ONSM. There was no difference in delay in diagnosis between patients with or without documented visual acuity.…”

Section: Dovepressmentioning

confidence: 82%

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Efficacy and Safety of Proton Beam Therapy for Primary Optic Nerve Sheath Meningioma

Hage

Alapetite

Brisse

et al. 2021

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Purpose Management of optic nerve sheath meningiomas (ONSM) remains challenging. Photon radiation therapy (PhRT) is the most common treatment for sight-threatening ONSM. Proton beam therapy (PBT) is less commonly used because it is more expensive and because there are questions about its efficacy specifically in relation to ONSM. PBT has the theoretical advantage of reducing radiation exposure to adjacent structures. We report the visual outcome of patients with primary ONSM managed at the Fondation Ophtalmologique Adolphe de Rothschild, Paris, France, and treated with PBT at the Centre de Protonthérapie, Institut Curie, Orsay, France. Methods We conducted a retrospective review of all patients with primary ONSM who received PBT (either by itself or following surgery) between January 2006 and January 2019. Neuro-ophthalmic examinations were performed at presentation and after radiotherapy, and, when applicable, after surgery. Meningiomas were measured at the time of diagnosis and at each follow-up MRI examination. Results Sixty patients (50 women, 10 men; mean age, 45.2±11.1y) were included, of whom 29 underwent surgery. At presentation, 52 (87%) of them had decreased vision (average visual acuity: 0.6 logMAR). Fundus examination showed optic disc swelling (n=27; 46.5%), optic disc pallor (n=22; 37.9%), optic disc cupping (n=2; 3.4%), opto-ciliary shunt (n=8; 13.8%), or choroidal folds (n=5; 8.6%). Otherwise, it was unremarkable (n=7; 12.1%). After treatment, visual function was stable overall. Fundus examination showed pallor (n=47; 83.9%), swelling (n=3; 5.4%), or cupping (n=2; 3.4%) of the optic disc, or was unremarkable (n=5; 8.9%). The visual field of 8 patients worsened, while 3 developed asymptomatic retinal hemorrhages. Tumor shrunk significantly in 8 patients at 1 year after PBT and remained stable in size in all others. Patients with opto-ciliary shunts had significantly worse visual outcome than other patients. Retinal abnormalities were observed in 11 patients during follow-up. Conclusion PBT alone or in association with surgery appears to be a safe and efficient treatment for ONSM, reducing the tumor size and stabilizing visual function. The risk of developing radiation retinopathy seems to be higher when patients had upfront surgery.

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Section: Dovepressmentioning

confidence: 82%

“… 26 Rassi et al reported that patients with good preoperative vision and CSF flow in the optic sheath had better chances of a favorable outcome than those with poor vision. 27 …”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Proton Beam Therapy for Primary Optic Nerve Sheath Meningioma

Hage

Alapetite

Brisse

et al. 2021

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“…In this retrospective analysis, the predictive factors that hold a great statistically significance were symptoms' duration, mild pre-operative visual affection, tumors less than 3cm, absence of arterial encasement and finally gross total resection [4,6,9,[11][12][13] .…”

Section: Discussionmentioning

confidence: 99%

“…Gross total resection was achieved in 19/24 (79.1%) of cases. Gross total resection is a common prognostic factor for visual recovery in many literatures [5,6,12,24,25] . This can be emphasized as Simpson GII resection provided the maximum decompression effect to optico-chiasmatic apparatus [24] .…”

Section: Discussionmentioning

confidence: 99%

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

Alsawy

2020

The Medical Journal of Cairo University

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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.

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Tumors of the Anterior Visual Pathways

Egan

2022

Albert and Jakobiec's Principles and Practice of Ophthalmology

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Prognostic factors in the surgical treatment of intracanalicular primary optic nerve sheath meningiomas

Cited by 14 publications

References 45 publications

Efficacy and Safety of Proton Beam Therapy for Primary Optic Nerve Sheath Meningioma

Efficacy and Safety of Proton Beam Therapy for Primary Optic Nerve Sheath Meningioma

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

Tumors of the Anterior Visual Pathways

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