Surgical management of suprasellar meningioma. Part 2: Prognosis for visual function following craniotomy.

Visual outcome in 101 consecutive cases of suprasellar meningioma treated over a 35-year period has been examined. Preoperative visual loss was evaluated using a scoring system that takes both visual acuity and visual fields into account. In this way a percentage visual loss was calculated for each patient before and after surgery. The effects on visual outcome of age, preoperative visual loss, duration of visual symptoms, tumor size, status of the optic disc, and binocular versus monocular involvement was examined. For the group as a whole, vision improved in 63 patients, was unchanged in 12 patients, and was worse in 24 patients. Prognosis was favorably affected by a mean duration of symptoms of less than 2 years, a tumor size of less than 3 cm, a preoperative visual loss of less than 50%, and the presence of normal optic discs on funduscopic examination. Age had some effect on prognosis, but the presence of binocular or monocular involvement had no effect.