方法：回顾分析2011-10/2015-10在首都医科大学附属北京天坛医院诊治的45例90眼侧脑室三角区脑膜瘤患者病例资料，对患者术前视力、视野、视乳头改变、肿瘤大小、肿瘤周围组织变化等进行分析。

结果：患者年龄12～68(平均41.7±13.7)岁，男女比例1：4.6； 视力下降18眼，视乳头水肿24眼，视乳头色淡6眼，视野缺损47眼，其中视野缺损类型以双眼对侧同向性缺损为主； 肿瘤最大径2.1～9.6(平均4.8±1.7)cm； 肿瘤体积3.02～193.2(平均48.3±47.8)cm³。Spearman分析显示肿瘤体积、肿瘤最大径和脑中线结构移位与术前出现视野缺损呈正相关。而患者年龄、性别、病程、脑室是否扩大、肿瘤周围组织是否水肿与术前出现视野缺损无明显相关性。经Mann-Whitney U检验，术前视野受损组和视野正常组之间肿瘤体积、肿瘤最大径、脑中线移位值均有显著性差异。

结论：较多三角区脑膜瘤患者存在眼部症状和体征，患者视功能损害的原因主要是由于肿瘤对周围视放射的破坏导致。肿瘤大小、生长方向、对周围视放射压迫的具体位置决定了患者是否出现视野缺损以及视野缺损的类型和程度。对于靠近视放射等后视路的颅脑占位，眼科医生和神经外科医生要重视其神经眼科学检查，注意肿瘤与周围视路等功能区的位置关系，这对于手术时机选择、手术方案制定及改善预后具有重要意义。

METHODS: Retrospectively study on the clinical data of 90 eyes in 45 patients diagnosed of trigonal meningiomas treated at Beijing Tian Tan Hospital from October 2011 to October 2015. Preoperative examinations including visual acuity, optic disc findings, visual field, size of tumors and other change in MRI were analyzed.

RESULTS: Patients' age was 12-68 years old(mean 41.7±13.7 years). Male/female ratio was 1:4.6. Decreased visual acuity occurred in 18 eyes. Optic disc edema was found in 24 eyes and optic disc pale in 6 eyes. Fourty-seven eyes had visual field defect, mostly homonymous hemianopia or defect. The maximum diameter of tumors was 2.1-9.6cm(4.8±1.7cm). Range of tumor volume was 3.02-193.2cm³(48.3±47.8cm³). A positive correlation of preoperative visual field defect was found with tumor volume, tumor maximum diameter, and brain midline shift respectively. While the preoperative visual field defect was not found any correlation with age, gender, course, and the enlargement of the ventricle and the edema of the tissue around the tumors. After Mann-Whitney U test, the differences on tumor volume, the maximum diameter of tumors, and brain midline shift between the two groups were significant.

CONCLUSION: Patients with trigonal meningiomas often have ocular signs and symptoms. The major reason of visual field defect is the damage of optic radiation around the tumor. The specific position of injured optic radiation determines the type and extent of visual field defect. Both ophthalmologist and neurosurgeon should pay attention to tumors nearby posterior visual pathway. Doing neurophthalmology examinations for these patients and realizing the position between the tumor and posterior visual pathway will be helpful and necessary in surgical planning.