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*Decreased vision
*Decreased vision
*Blindness
*Blindness
*Hydrocephalus
*Growth horme deficiency
*Precocious puberty
Vision may be seriously impaired in patients with optic nerve gliomas.<ref name="pmid7842408">{{cite journal| author=Janss AJ, Grundy R, Cnaan A, Savino PJ, Packer RJ, Zackai EH et al.| title=Optic pathway and hypothalamic/chiasmatic gliomas in children younger than age 5 years with a 6-year follow-up. | journal=Cancer | year= 1995 | volume= 75 | issue= 4 | pages= 1051-9 | pmid=7842408 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7842408  }} </ref><ref name="pmid7674005">{{cite journal| author=Sutton LN, Molloy PT, Sernyak H, Goldwein J, Phillips PL, Rorke LB et al.| title=Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery. | journal=J Neurosurg | year= 1995 | volume= 83 | issue= 4 | pages= 583-9 | pmid=7674005 | doi=10.3171/jns.1995.83.4.0583 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7674005  }} </ref><ref name="pmid17704361">{{cite journal| author=Dalla Via P, Opocher E, Pinello ML, Calderone M, Viscardi E, Clementi M et al.| title=Visual outcome of a cohort of children with neurofibromatosis type 1 and optic pathway glioma followed by a pediatric neuro-oncology program. | journal=Neuro Oncol | year= 2007 | volume= 9 | issue= 4 | pages= 430-7 | pmid=17704361 | doi=10.1215/15228517-2007-031 | pmc=PMC1994100 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17704361  }} </ref>. Significant visual impairment is  frequently present in NF-1 patients with optic nerve gliomas.<ref name="pmid17704361">{{cite journal| author=Dalla Via P, Opocher E, Pinello ML, Calderone M, Viscardi E, Clementi M et al.| title=Visual outcome of a cohort of children with neurofibromatosis type 1 and optic pathway glioma followed by a pediatric neuro-oncology program. | journal=Neuro Oncol | year= 2007 | volume= 9 | issue= 4 | pages= 430-7 | pmid=17704361 | doi=10.1215/15228517-2007-031 | pmc=PMC1994100 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17704361  }} </ref><ref name="pmid20400294">{{cite journal| author=Moreno L, Bautista F, Ashley S, Duncan C, Zacharoulis S| title=Does chemotherapy affect the visual outcome in children with optic pathway glioma? A systematic review of the evidence. | journal=Eur J Cancer | year= 2010 | volume= 46 | issue= 12 | pages= 2253-9 | pmid=20400294 | doi=10.1016/j.ejca.2010.03.028 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20400294  }} </ref> In adults the clinical course of an optic nerve gliomas resembles the behavior of the tumors's histology, which is commonly a malignant glioma. Malignant optic nerve gliomas can result in rapidly progressive visual loss. Rapid  onset blindness is seen in elderly and middle-aged individuals.<ref name="pmid7469853">{{cite journal| author=Spoor TC, Kennerdell JS, Zorub D, Martinez AJ| title=Progressive visual loss due to glioblastoma: normal neuroroentgenorgraphic studies. | journal=Arch Neurol | year= 1981 | volume= 38 | issue= 3 | pages= 196-7 | pmid=7469853 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7469853  }} </ref><ref name="pmid6243868">{{cite journal| author=Spoor TC, Kennerdell JS, Martinez AJ, Zorub D| title=Malignant gliomas of the optic nerve pathways. | journal=Am J Ophthalmol | year= 1980 | volume= 89 | issue= 2 | pages= 284-92 | pmid=6243868 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6243868  }} </ref><ref name="pmid10536925">{{cite journal| author=Dario A, Iadini A, Cerati M, Marra A| title=Malignant optic glioma of adulthood. Case report and review of the literature. | journal=Acta Neurol Scand | year= 1999 | volume= 100 | issue= 5 | pages= 350-3 | pmid=10536925 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10536925  }} </ref> Death can occur with in few months of presentation if tumor invasion into adjacent brain occurs.<ref name="pmid2643688">{{cite journal| author=Taphoorn MJ, de Vries-Knoppert WA, Ponssen H, Wolbers JG| title=Malignant optic glioma in adults. Case report. | journal=J Neurosurg | year= 1989 | volume= 70 | issue= 2 | pages= 277-9 | pmid=2643688 | doi=10.3171/jns.1989.70.2.0277 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2643688  }} </ref>
Vision may be seriously impaired in patients with optic nerve gliomas.<ref name="pmid7842408">{{cite journal| author=Janss AJ, Grundy R, Cnaan A, Savino PJ, Packer RJ, Zackai EH et al.| title=Optic pathway and hypothalamic/chiasmatic gliomas in children younger than age 5 years with a 6-year follow-up. | journal=Cancer | year= 1995 | volume= 75 | issue= 4 | pages= 1051-9 | pmid=7842408 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7842408  }} </ref><ref name="pmid7674005">{{cite journal| author=Sutton LN, Molloy PT, Sernyak H, Goldwein J, Phillips PL, Rorke LB et al.| title=Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery. | journal=J Neurosurg | year= 1995 | volume= 83 | issue= 4 | pages= 583-9 | pmid=7674005 | doi=10.3171/jns.1995.83.4.0583 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7674005  }} </ref><ref name="pmid17704361">{{cite journal| author=Dalla Via P, Opocher E, Pinello ML, Calderone M, Viscardi E, Clementi M et al.| title=Visual outcome of a cohort of children with neurofibromatosis type 1 and optic pathway glioma followed by a pediatric neuro-oncology program. | journal=Neuro Oncol | year= 2007 | volume= 9 | issue= 4 | pages= 430-7 | pmid=17704361 | doi=10.1215/15228517-2007-031 | pmc=PMC1994100 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17704361  }} </ref>. Significant visual impairment is  frequently present in NF-1 patients with optic nerve gliomas.<ref name="pmid17704361">{{cite journal| author=Dalla Via P, Opocher E, Pinello ML, Calderone M, Viscardi E, Clementi M et al.| title=Visual outcome of a cohort of children with neurofibromatosis type 1 and optic pathway glioma followed by a pediatric neuro-oncology program. | journal=Neuro Oncol | year= 2007 | volume= 9 | issue= 4 | pages= 430-7 | pmid=17704361 | doi=10.1215/15228517-2007-031 | pmc=PMC1994100 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17704361  }} </ref><ref name="pmid20400294">{{cite journal| author=Moreno L, Bautista F, Ashley S, Duncan C, Zacharoulis S| title=Does chemotherapy affect the visual outcome in children with optic pathway glioma? A systematic review of the evidence. | journal=Eur J Cancer | year= 2010 | volume= 46 | issue= 12 | pages= 2253-9 | pmid=20400294 | doi=10.1016/j.ejca.2010.03.028 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20400294  }} </ref> In adults the clinical course of an optic nerve gliomas resembles the behavior of the tumors's histology, which is commonly a malignant glioma. Malignant optic nerve gliomas can result in rapidly progressive visual loss. Rapid  onset blindness is seen in elderly and middle-aged individuals.<ref name="pmid7469853">{{cite journal| author=Spoor TC, Kennerdell JS, Zorub D, Martinez AJ| title=Progressive visual loss due to glioblastoma: normal neuroroentgenorgraphic studies. | journal=Arch Neurol | year= 1981 | volume= 38 | issue= 3 | pages= 196-7 | pmid=7469853 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7469853  }} </ref><ref name="pmid6243868">{{cite journal| author=Spoor TC, Kennerdell JS, Martinez AJ, Zorub D| title=Malignant gliomas of the optic nerve pathways. | journal=Am J Ophthalmol | year= 1980 | volume= 89 | issue= 2 | pages= 284-92 | pmid=6243868 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6243868  }} </ref><ref name="pmid10536925">{{cite journal| author=Dario A, Iadini A, Cerati M, Marra A| title=Malignant optic glioma of adulthood. Case report and review of the literature. | journal=Acta Neurol Scand | year= 1999 | volume= 100 | issue= 5 | pages= 350-3 | pmid=10536925 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10536925  }} </ref> Death can occur with in few months of presentation if tumor invasion into adjacent brain occurs.<ref name="pmid2643688">{{cite journal| author=Taphoorn MJ, de Vries-Knoppert WA, Ponssen H, Wolbers JG| title=Malignant optic glioma in adults. Case report. | journal=J Neurosurg | year= 1989 | volume= 70 | issue= 2 | pages= 277-9 | pmid=2643688 | doi=10.3171/jns.1989.70.2.0277 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2643688  }} </ref>
==Prognosis==
==Prognosis==

Revision as of 14:10, 30 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Natural History

Optic nerve gliomas have an unpredictable natural history. Vision of patients with optic nerve gliomas can be stabilized, and in some cases improved by chemotherapy and radiation therapy. The treatment of optic nerve glioma requires A multi-disciplinary approach is required in the treatment of optic nerve gliomas, where all treatment options may have to be carried out in a highly individualized manner.[1]

Complications

  • Decreased vision
  • Blindness
  • Hydrocephalus
  • Growth horme deficiency
  • Precocious puberty

Vision may be seriously impaired in patients with optic nerve gliomas.[2][3][4]. Significant visual impairment is frequently present in NF-1 patients with optic nerve gliomas.[4][5] In adults the clinical course of an optic nerve gliomas resembles the behavior of the tumors's histology, which is commonly a malignant glioma. Malignant optic nerve gliomas can result in rapidly progressive visual loss. Rapid onset blindness is seen in elderly and middle-aged individuals.[6][7][8] Death can occur with in few months of presentation if tumor invasion into adjacent brain occurs.[9]

Prognosis

These tumours demonstrate variable clinical and radiological progression. In patients with NF1 it is not unusual for these tumours to be quiescent, with little progression demonstrated over a number of years. In others, the tumours are more aggressive with extension along the optic pathways.[10] Normally, the growth of the tumor is very slow, and the condition remains stable for long periods of time. However, in adults and some children, when the optic chiasm is involved, the tumor is more aggressive.[11] There is nearly 90 percent survival rate for optic pathway gliomas. Children with neurofibromatosis and older children have a better prognosis. Spontaneous remission of the optic pathway gliomas is seen in two-thirds of children with NF-1. The clinical course of optic nerve gliomas is unpredictable.[12] Metastatic dissemination through ventriculoperitoneal shunts , malignant degeneration, and spontaneous regression have all been reported. In adults the optic nerve gliomas tend to be histologically anaplastic and display aggressive clinical course.[13][14][15] In children, in contrast the variable clinical course of OPGs is more a function of location than specific histology.[16][17] Excellent prognosis with a median survival of more than 15 years is seen in children with intracranial and intraorbital tumors.[18] Patients with chiasmal gliomas have usually less favorable prognosis. Better prognosis is seen in patients with optic nerve gliomas associated with neurofibromatosis type 1, due to predominance of anterior lesions. Patients with neurofibromatosis type 1 have appoximately twice the recurrence rate following complete excision of an intraorbital glioma as compared with patients without NF-1. However, similar prognosis following radiation of a optic nerve gliomas has been seen in patients with NF-1, as compared to patients without NF-1.[19][20][21]

References

  1. ↑ Nair AG, Pathak RS, Iyer VR, Gandhi RA (2014). "Optic nerve glioma: an update". Int Ophthalmol. 34 (4): 999–1005. doi:10.1007/s10792-014-9942-8. PMID 24736941.
  2. ↑ Janss AJ, Grundy R, Cnaan A, Savino PJ, Packer RJ, Zackai EH; et al. (1995). "Optic pathway and hypothalamic/chiasmatic gliomas in children younger than age 5 years with a 6-year follow-up". Cancer. 75 (4): 1051–9. PMID 7842408.
  3. ↑ Sutton LN, Molloy PT, Sernyak H, Goldwein J, Phillips PL, Rorke LB; et al. (1995). "Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery". J Neurosurg. 83 (4): 583–9. doi:10.3171/jns.1995.83.4.0583. PMID 7674005.
  4. ↑ 4.0 4.1 Dalla Via P, Opocher E, Pinello ML, Calderone M, Viscardi E, Clementi M; et al. (2007). "Visual outcome of a cohort of children with neurofibromatosis type 1 and optic pathway glioma followed by a pediatric neuro-oncology program". Neuro Oncol. 9 (4): 430–7. doi:10.1215/15228517-2007-031. PMC 1994100. PMID 17704361.
  5. ↑ Moreno L, Bautista F, Ashley S, Duncan C, Zacharoulis S (2010). "Does chemotherapy affect the visual outcome in children with optic pathway glioma? A systematic review of the evidence". Eur J Cancer. 46 (12): 2253–9. doi:10.1016/j.ejca.2010.03.028. PMID 20400294.
  6. ↑ Spoor TC, Kennerdell JS, Zorub D, Martinez AJ (1981). "Progressive visual loss due to glioblastoma: normal neuroroentgenorgraphic studies". Arch Neurol. 38 (3): 196–7. PMID 7469853.
  7. ↑ Spoor TC, Kennerdell JS, Martinez AJ, Zorub D (1980). "Malignant gliomas of the optic nerve pathways". Am J Ophthalmol. 89 (2): 284–92. PMID 6243868.
  8. ↑ Dario A, Iadini A, Cerati M, Marra A (1999). "Malignant optic glioma of adulthood. Case report and review of the literature". Acta Neurol Scand. 100 (5): 350–3. PMID 10536925.
  9. ↑ Taphoorn MJ, de Vries-Knoppert WA, Ponssen H, Wolbers JG (1989). "Malignant optic glioma in adults. Case report". J Neurosurg. 70 (2): 277–9. doi:10.3171/jns.1989.70.2.0277. PMID 2643688.
  10. ↑ "Radiopedia optic nerve glioma prognosis".
  11. ↑ "NIH optic nerve glioma prognosis".
  12. ↑ Shuper A, Horev G, Kornreich L, Michowiz S, Weitz R, Zaizov R; et al. (1997). "Visual pathway glioma: an erratic tumour with therapeutic dilemmas". Arch Dis Child. 76 (3): 259–63. PMC 1717103. PMID 9135269.
  13. ↑ Hamilton AM, Garner A, Tripathi RC, Sanders MD (1973). "Malignant optic nerve glioma. Report of a case with electron microscope study". Br J Ophthalmol. 57 (4): 253–64. PMC 1214877. PMID 4707622.
  14. ↑ Gibberd FB, Miller TN, Morgan AD (1973). "Glioblastoma of the optic chiasm". Br J Ophthalmol. 57 (10): 788–91. PMC 1215165. PMID 4361475.
  15. ↑ Hoyt WF, Meshel LG, Lessell S, Schatz NJ, Suckling RD (1973). "Malignant optic glioma of adulthood". Brain. 96 (1): 121–32. PMID 4695718.
  16. ↑ Borit A, Richardson EP (1982). "The biological and clinical behaviour of pilocytic astrocytomas of the optic pathways". Brain. 105 (Pt 1): 161–87. PMID 7066671.
  17. ↑ Rush JA, Younge BR, Campbell RJ, MacCarty CS (1982). "Optic glioma. Long-term follow-up of 85 histopathologically verified cases". Ophthalmology. 89 (11): 1213–9. PMID 6818504.
  18. ↑ Alvord EC, Lofton S (1988). "Gliomas of the optic nerve or chiasm. Outcome by patients' age, tumor site, and treatment". J Neurosurg. 68 (1): 85–98. doi:10.3171/jns.1988.68.1.0085. PMID 3275755.
  19. ↑ Listernick R, Louis DN, Packer RJ, Gutmann DH (1997). "Optic pathway gliomas in children with neurofibromatosis 1: consensus statement from the NF1 Optic Pathway Glioma Task Force". Ann Neurol. 41 (2): 143–9. doi:10.1002/ana.410410204. PMID 9029062.
  20. ↑ Listernick R, Charrow J, Greenwald MJ, Esterly NB (1989). "Optic gliomas in children with neurofibromatosis type 1". J Pediatr. 114 (5): 788–92. PMID 2497236.
  21. ↑ Deliganis AV, Geyer JR, Berger MS (1996). "Prognostic significance of type 1 neurofibromatosis (von Recklinghausen Disease) in childhood optic glioma". Neurosurgery. 38 (6): 1114–8, discussion 1118-9. PMID 8727140.

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