title: Visual disability rates in a ten-year cohort of patients with anterior visual pathway meningiomas.
abstract: OBJECTIVE
  To examine the visual outcome of anterior visual pathway meningioma (AVPM) patients followed for at least one year.
  
  
  METHODS
  Data were collected on demographics, clinical course and management. Visual disability was classified at the first and last examination as follows: I--no visual disability; II--mild visual defect in one eye; III--mild visual defect in both eyes; IV--loss of driver's license; V--legally blind.
  
  
  RESULTS
  Eight-one AVPM patients had their tumor originate in the clinoid process in 23 (28%), sphenoid-wing area in 18 (22%), cavernous sinus in 15 (19%), tuberculum sellae in 8 (10%), and mixed in 17 (21%). On last examination, 46 patients (57%) had good visual acuity in one or both eyes (Class I or II) and 17 (21%) were mildly affected in both eyes. The rate of Class IV disability was 16%, and Class V disability was 6%.
  
  
  CONCLUSIONS
  Attention needs to be addressed to the considerable proportion of patients with AVPM (22% in this study) who may lose their driver's license or become legally blind. Occupational therapists should play an important role in the multidisciplinary management of those patients to help them adapt to their new physical and social situation.
  
  
  CONCLUSIONS
  Anterior visual pathway meningiomas (AVPMs) are commonly not life-threatening but they can lead to profound visual disability, especially when the tumor originates in the tuberculum sellae and cavernous sinus. Particular attention should be paid to visual acuity and visual field deficits, as these can profoundly affect the patient's quality of life including ability to drive and activities of daily living. The interdisciplinary management of patients with AVPM should include the neurosurgeon, neuro-ophthalmologist and occupational therapist. Also, early intervention by the occupational therapist can help patients adapt to their current physical and social situation and return to everyday tasks more rapidly.
authors.affiliation: Department of Ophthalmology, Rabin Medical Center - Beilinson Campus , Petach Tikva , Israel .
authors.forename: Elite
authors.initials: E
authors.lastname: Bor-Shavit
authors.forename: Naama
authors.initials: N
authors.lastname: Hammel
authors.forename: Yoav
authors.initials: Y
authors.lastname: Nahum
authors.forename: Zvi Harry
authors.initials: ZH
authors.lastname: Rappaport
authors.forename: Hadas
authors.initials: H
authors.lastname: Stiebel-Kalish
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000175:diagnosis; D008579:Meningioma / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D011788:Quality of Life; D012658:Sella Turcica / Q000473:pathology; D013100:Sphenoid Bone / Q000473:pathology; D062606:Tertiary Care Centers; D014786:Vision Disorders / Q000145:classification*; D014792:Visual Acuity; D014794:Visual Fields; D014795:Visual Pathways / Q000503:physiopathology*
keywords: Blindness; loss of driver’s license; optic nerve; tumor; vision