Visual acuity (VA) constitutes an important outcome measure in surgery for medial sphenoid wing meningioma (SWM). This study aimed to assess the recovery of tumor-associated impairment of visual acuity and its impact on patient-reported outcome measures (PROMs) as an indication for vision-related quality of life (QoL) in patients that had undergone surgery for medial SWM.

From 2010 to 2018, 153 consecutive patients with medial SWM underwent surgical treatment at the authors" institutions. Tumor-associated visual acuity was evaluated both upon admission and during postoperative follow-up examinations, employing Snellen charts. Multivariable analysis was performed to identify independent predictors for postoperative improvement of visual acuity. PROMs were collected based on The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25).

A total of 53 of 153 patients with medial SWM (35%) suffered from preoperative impairment of visual acuity. Mean preoperative duration of visual symptoms was 12 ± 9 months for the entire study cohort. Multivariable analysis revealed preoperative duration of visual symptoms for ≤ 4 months to be independently associated with postoperative improvement of visual acuity (p=0.009). Evaluation of PROMs indicated a superior postoperative qualitative extent in the categories "overall health" (p=0.027) and "activities of daily life" (p=0.033) if preoperative duration of visual impairment was ≤ 4 months.

Preoperative overall duration of tumor-related visual impairment significantly correlates to the extent of postoperative visual improvement as well as vision-related PROMs in medial SWM surgery. These results might aid preoperative patient counseling, optimized decision-making, and preoperative estimation of long-term visual outcome.