Abstract / Summary
The purpose of this study was to evaluate the efficacy and safety of CyberKnife (CK) radiosurgery in patients with optic nerve sheath meningiomas (ONSM). We retrospectively identified patients with ONSM treated with CK between January 2020 and January 2024 from the Database of Chinese Neuro-Ophthalmic Diseases. CK was delivered at 23–25 Gy in 5 fractions. Best-corrected visual acuity (BCVA) and visual field mean deviation (VF MD) were assessed before treatment and at the final follow-up, with a median visual follow-up of 36 months (range, 26–64 months). Tumor volume and CK-related complications were also evaluated. Twenty patients (22 affected eyes; 2 with bilateral involvement) were included. Treatment success was achieved in 90.9% (20/22) of eyes, including improvement in 59.1% (13/22) and stable visual function in 31.8% (7/22), whereas 9.1% (2/22) worsened. Among the 12 eyes with available VF MD data, 91.7% (11/12) improved and 8.3% (1/12) worsened. Spearman correlation analysis revealed that poorer baseline BCVA (r = 0.457, p = 0.032) and a longer interval from onset to CK (r = 0.450, p = 0.036) were associated with poorer visual outcomes, whereas age and tumor volume were not significantly associated with visual changes (p > 0.05). MRI follow-up was available for 13 patients (14 eyes), with tumor control achieved in all 14 eyes. No serious treatment-related complications were observed. CK hypofractionated radiosurgery may preserve and improve visual function in ONSM, providing a potentially safe and effective treatment option.