title: Surgical Indications of Exploring Optic Canal and Visual Prognostic Factors in Neurosurgical Treatment of Tuberculum Sellae Meningiomas.
abstract: BACKGROUND
  Tuberculum sellae meningiomas (TSMs) present a special symptom because of the adherence and compression to the optic nerve, optic artery, and the chiasm. A significant number of patients with TSMs appear visual deficits. This study aimed to investigate the surgical indications of exploring the optic canal and visual prognostic factors in the neurosurgical treatment of TSMs.
  
  
  METHODS
  Totally 21 patients with TSM, who were operated from September 2007 to August 2011 in the Department of Neurosurgery, Tongren Hospital were enrolled in this study. Results of orbital computed tomography (CT) and magnetic resonance imaging (MRI), visual acuity, Goldmann visual field test, orbital color Doppler flow imaging (CDI) test in these patients were retrospectively analyzed.
  
  
  RESULTS
  Visual deficit and optic canal involvement (OCI) were detected in all the 21 patients. Fourteen patients had bone proliferation within the area of the optic canal. After the operation, visual outcomes were improved in 13 patients, unchanged in 7 patients, and deteriorated in 1 patient. All the 21 patients performed orbital CDI test preoperatively, the results showed that if the peak systolic velocity (PSV) of central retinal artery (CRA) value was ≤ 8 cm/s, the visual outcome would be better.
  
  
  CONCLUSIONS
  The surgical indications of exploring optic canal in TSM cases included: (1) The neuroimaging evidences of OCI (CT and/or MRI); (2) PSV of CRA in orbital CDI test was ≤ 8 cm/s; (3) visual acuity was below 0.1; (4) visual field deficit. The PSV of CRA in CDI test could be a prognostic factor for visual outcomes of TSMs.
authors: Hao-Cheng
authors: HC
authors: Liu
authors: E
authors: E
authors: Qiu
authors: Jia-Liang
authors: JL
authors: Zhang
authors: Jun
authors: J
authors: Kang
authors: Yong
authors: Y
authors: Li
authors: Yong
authors: Y
authors: Li
authors: Li-Bin
authors: LB
authors: Jiang
authors: Department of Neurosurgery, Tongren Hospital, Capital Medical University, Beijing 100730, China.
authors: Ji-Di
authors: JD
authors: Fu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery; D014792:Visual Acuity