Abstract:AIM: To analyze the ocular manifestations of meningiomas in the trigone of the lateral ventricle, discuss the relevant factors of visual impairment in these patients and things need attention clinically.
METHODS: Retrospectively study on the clinical data of 90 eyes in 45 patients diagnosed of trigonal meningiomas treated at Beijing Tian Tan Hospital from October 2011 to October 2015. Preoperative examinations including visual acuity, optic disc findings, visual field, size of tumors and other change in MRI were analyzed.
RESULTS: Patients' age was 12-68 years old(mean 41.7±13.7 years). Male/female ratio was 1:4.6. Decreased visual acuity occurred in 18 eyes. Optic disc edema was found in 24 eyes and optic disc pale in 6 eyes. Fourty-seven eyes had visual field defect, mostly homonymous hemianopia or defect. The maximum diameter of tumors was 2.1-9.6cm(4.8±1.7cm). Range of tumor volume was 3.02-193.2cm3(48.3±47.8cm3). A positive correlation of preoperative visual field defect was found with tumor volume, tumor maximum diameter, and brain midline shift respectively. While the preoperative visual field defect was not found any correlation with age, gender, course, and the enlargement of the ventricle and the edema of the tissue around the tumors. After Mann-Whitney U test, the differences on tumor volume, the maximum diameter of tumors, and brain midline shift between the two groups were significant.
CONCLUSION: Patients with trigonal meningiomas often have ocular signs and symptoms. The major reason of visual field defect is the damage of optic radiation around the tumor. The specific position of injured optic radiation determines the type and extent of visual field defect. Both ophthalmologist and neurosurgeon should pay attention to tumors nearby posterior visual pathway. Doing neurophthalmology examinations for these patients and realizing the position between the tumor and posterior visual pathway will be helpful and necessary in surgical planning.
