Ophthalmological features of optic canal involvement in parasellar and cranio-orbital meningiomas

Optic canal involvement in parasellar and cranio-orbital meningiomas is a clinically significant factor that determines the pattern of visual impairment and influences surgical strategy; however, its preoperative diagnosis remains challenging despite the use of advanced neuroimaging techniques. The aim of this study was to identify clinical, anamnestic, and neuro-ophthalmological features associated with optic canal involvement and evaluate their diagnostic value based on intraoperative verification. A retrospective analysis of 108 patients with parasellar and cranio-orbital meningiomas complicated by non-traumatic optic neuropathy was performed; visual disorders were analyzed in 138 affected eyes. The clinical course of the disease, best-corrected visual acuity, visual field defects, optic disc status, and MRI findings were assessed. Optic canal involvement was identified in 72.5% of the cases. An acute-onset progressive course was significantly associated with intracanalar tumor growth (OR 17.96; p