title: Use of optical coherence tomography in predicting post-treatment visual outcome in anterior visual pathway meningiomas.
abstract: OBJECTIVE
  To determine the prognostic value of pretreatment optical coherence tomography (OCT) measurement of the peripapillary retinal nerve fibre layer (PRNFL) in final visual outcomes of patients with anterior visual pathway meningioma and optic neuropathy.
  
  
  METHODS
  Retrospective case series from a tertiary care academic referral centre. Fourteen eyes (12 patients) in which pretreatment and post-treatment OCT, visual field and comprehensive neuro-ophthalmic exam data were available were evaluated for visual acuity, colour vision and visual field change after neurosurgical and/or radiation oncologic treatment.
  
  
  RESULTS
  Twelve patients and 14 eyes were analysed. Patients had tumours centred at the tuberculum sella (3), planum sphenoidale (3), anterior clinoid (2), optic nerve sheath (2), sphenoid wing (2) and olfactory groove (1). Nine eyes had normal PRNFL thickness (mean 95.5 μm± 11.0), whereas five eyes had thin PRNFL (mean 66.0 μm ± 14.2). The mean duration of follow-up was 9.7 months. There was no significant difference in age, duration of symptoms or duration of follow-up between both groups (p=0.22). After treatment, the normal PRNFL group experienced significant improvement in the visual acuity (p=0.03), colour vision (p=0.016), perimetric mean deviation (p=0.019) and foveal threshold (p=0.016) but not pattern SD (p=0.074) compared with the group with thin PRNFL. On multivariate analysis, duration of symptoms, but neither age nor follow-up duration, predicted final visual outcome.
  
  
  CONCLUSIONS
  Patients with compressive optic neuropathy due to anterior pathway meningiomas are more likely to improve post-treatment if they have a normal pretreatment PRNFL and shorter duration of symptoms.
authors: Neuro-Ophthalmology Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, , Baltimore, Maryland, USA.
authors: Jing-Liang
authors: JL
authors: Loo
authors: Jing
authors: J
authors: Tian
authors: Neil R
authors: NR
authors: Miller
authors: Prem S
authors: PS
authors: Subramanian
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D008579:Meningioma / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012165:Retinal Ganglion Cells / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D014794:Visual Fields; D014795:Visual Pathways / Q000473:pathology*
keywords: Diagnostic Tests/Investigation; Field of Vision; Optic Nerve; Visual Pathway