Postoperative Vision-Related Quality of Life After Sphenoid Wing Meningioma Surgery: Impact of Radiomic Shape Features and Age

<b>Background:</b> Sphenoid wing meningiomas (SWM) frequently compress structures of the optic pathway, resulting in significant visual dysfunction characterized by vision loss and visual field deficits, which profoundly impact patients' quality of life (QoL), daily activities, and independence. The objective of this study was to assess the impact of SWM surgery on patient-reported outcome measures (PROMs) regarding postoperative visual function. <b>Methods:</b> The Visual Function Score Questionnaire (VFQ-25) is a validated tool designed to assess the impact of visual impairment on quality of life. The questionnaire was distributed to a previously published study population in which shape radiomics were correlated with new cranial nerve deficits after SWM surgery. <b>Results:</b> A total of 42 patients (42/74; 56.8%) responded to the questionnaire. Of the 42 patients, 30 were female (71%) and 12 were male (29%). The multivariable analysis demonstrated that lower sphericity reflecting irregular SWM shape was associated with poorer VFQ-25 (OR: 6.8, 95% CI: 1.141.8, <i>p</i> = 0.039), while age was associated with lower VFQ-25 (OR: 27, 95% CI: 2.7-272.93, <i>p</i> = 0.005), too. Analysis of the subcategories of the VFQ-25 revealed significantly reduced general vision (<i>p</i> = 0.045), social functioning (<i>p</i> = 0.045), and peripheral vision (<i>p</i> = 0.017) in those with SWM with low sphericity. <b>Conclusions:</b> The study highlights that SWM surgery impacts postoperative visual function, with age and irregular SWM shape being associated with poorer postoperative VFQ-25 scores. VFQ-25 is a feasible tool to assess vision outcome in SWM surgery and has clinical potential for longitudinal follow-up evaluations. Irregular SWM shape should be considered during preoperative treatment planning and patient consultation regarding functional outcome.