Abstract
<title>Abstract</title> <p>Purpose: Compressive optic neuropathy is one of the causes of visual loss with different etiologies. Meningiomas account for 36% of intracranial tumors. The rate of visual loss for suprasellar and clinoid meningiomas ranges from 53.8 to 77%. This article aims to evaluate the compressive optic neuropathy repercussion due to a skull base tumor on the visual cortex (trans-synaptic degeneration). Method : Observational study conducted with patients divided into a group with severe visual loss due to meningiomas and another group with normal vision. All patients underwent ophthalmologic evaluation and magnetic resonance imaging with volumetric T1 sequences. Using the FreeSurfer software, volumetric analysis of the primary visual area was then performed. The comparison between the groups was performed using the Mann-Whitney test. Results : 51 patients, divided into two groups: a group of 26 patients with severe visual loss and a group of 25 with normal vision. We observed a volumetric reduction in the right primary visual area and the right lateral geniculate nucleus in an intention-to-treat analysis (p = 0.029 and p = 0.041, respectively). In a sensitivity analysis, including only patients with complete vision loss, we observed statistically significant atrophy of the right lateral geniculate nucleus, right primary visual area, and bilateral primary visual area (p = 0.034, p = 0.024, and p = 0.034, respectively). The difference in the left visual area was close to statistical significance (p = 0.061). Conclusion compressive visual loss due to meningioma causes atrophy of the visual cortex through anterograde transsynaptic degeneration.</p>