Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors

To determine visual outcome including the occurrence of radiation induced optic neuropathy (RION) as well as tumor control after fractionated stereotactic radiation therapy (FSRT) of benign anterior skull base meningiomas or pituitary adenomas. Thirty-nine patients treated with FSRT for anterior skull base meningiomas and 55 patients treated with FSRT for pituitary adenomas between January 1999 and December 2009 with at least 2 years follow-up were included. Patients were followed up prospectively with magnetic resonance imaging scans, visual acuity and visual field examinations. RION was found in four (10 %) patients with anterior skull base meningiomas and seven patients (13 %) with pituitary adenomas. The five-year actuarial freedom from 25 % RION visual field loss was 94 % following FSRT. Actuarial 2-, 5- and 10-year tumor control rates were 100, 88.4 and 64.5 % for anterior skull base meningiomas and 100, 98.2 and 94.9 % for pituitary adenomas, respectively. Patients with an impaired visual field function pre-FSRT were more likely to experience worsened function (p = 0.016). We found that RION, was a relatively uncommon event, in a large prospective cohort of patients that were systematically monitored following FSRT of benign anterior skull base tumors. Long term tumor control was favorable, especially for pituitary adenomas

Head-to-Head Comparison of Ultrasound Versus Temporal Artery Biopsy in the Diagnosis of Giant Cell Arteritis

Giant cell arteritis (GCA) is a medical and ophthalmological emergency due to risk of sudden irreversible loss of vision and stroke. Accurate diagnosis is important to prevent complications and high dose glucocorticoids toxicity. Temporal artery biopsy (TAB) is generally considered as the diagnostic gold standard for diagnosing GCA. However, ultrasound (US) is a fast and non-invasive procedure, and is now a recommended alternative to TAB. The purpose of this study was to assess the diagnostic performance of US and TAB in the diagnosis of GCA