Optic nerve glioma natural history, complications and prognosis: Difference between revisions

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*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.<ref name="pmid9029062">{{cite journal| author=Listernick R, Louis DN, Packer RJ, Gutmann DH| title=Optic pathway gliomas in children with neurofibromatosis 1: consensus statement from the NF1 Optic Pathway Glioma Task Force. | journal=Ann Neurol | year= 1997 | volume= 41 | issue= 2 | pages= 143-9 | pmid=9029062 | doi=10.1002/ana.410410204 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9029062  }} </ref><ref name="pmid2497236">{{cite journal| author=Listernick R, Charrow J, Greenwald MJ, Esterly NB| title=Optic gliomas in children with neurofibromatosis type 1. | journal=J Pediatr | year= 1989 | volume= 114 | issue= 5 | pages= 788-92 | pmid=2497236 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2497236  }} </ref><ref name="pmid8727140">{{cite journal| author=Deliganis AV, Geyer JR, Berger MS| title=Prognostic significance of type 1 neurofibromatosis (von Recklinghausen Disease) in childhood optic glioma. | journal=Neurosurgery | year= 1996 | volume= 38 | issue= 6 | pages= 1114-8; discussion 1118-9 | pmid=8727140 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8727140  }} </ref>  
*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.<ref name="pmid9029062">{{cite journal| author=Listernick R, Louis DN, Packer RJ, Gutmann DH| title=Optic pathway gliomas in children with neurofibromatosis 1: consensus statement from the NF1 Optic Pathway Glioma Task Force. | journal=Ann Neurol | year= 1997 | volume= 41 | issue= 2 | pages= 143-9 | pmid=9029062 | doi=10.1002/ana.410410204 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9029062  }} </ref><ref name="pmid2497236">{{cite journal| author=Listernick R, Charrow J, Greenwald MJ, Esterly NB| title=Optic gliomas in children with neurofibromatosis type 1. | journal=J Pediatr | year= 1989 | volume= 114 | issue= 5 | pages= 788-92 | pmid=2497236 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2497236  }} </ref><ref name="pmid8727140">{{cite journal| author=Deliganis AV, Geyer JR, Berger MS| title=Prognostic significance of type 1 neurofibromatosis (von Recklinghausen Disease) in childhood optic glioma. | journal=Neurosurgery | year= 1996 | volume= 38 | issue= 6 | pages= 1114-8; discussion 1118-9 | pmid=8727140 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8727140  }} </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>


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Revision as of 20:34, 5 October 2015

Optic nerve glioma Microchapters

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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

If left untreated, less than 5 percentage of patients with optic nerve gliomas may progress to develop blindness. Common complications of optic nerve glioma include decreased vision, blindness, growth hormone deficiency, precocious puberty, and hydrocephalus. Prognosis is generally good in most patients with optic pathway gliomas. Most optic nerve gliomas are benign and produce slowly progressive visual loss associated with variable proptosis and anterior or posterior optic neuropathy.

Natural History

Optic nerve gliomas have an unpredictable natural history.[1] Most of the optic nerve gliomas grow slowly in a self limited manner and some of them spontaneously regress.[2] If left untreated, less than 5 percentage of patients with optic nerve gliomas may progress to develop blindness. Significant visual impairment is frequently present in NF-1 patients with optic nerve gliomas.[3][4] These tumors demonstrate variable clinical and radiological progression. In patients with neurofibromatosis type 1 it is not unusual for these tumors to be quiescent, with little progression demonstrated over a number of years. In others, the tumors are more aggressive with extension along the optic pathways.[5] 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.[6]

Complications

Complications of optic nerve gliomas include:[6]

Prognosis

  • There is nearly 90 percent survival rate for all optic pathway gliomas whether those with or without neurofibromatosis type 1.
  • 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.[7]
  • 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.[8][9][10]
  • In children, in contrast the variable clinical course of Optic pathway glioma is more a function of location than specific histology.[11][12]
  • Excellent prognosis with a median survival of more than 15 years is seen in children with intracranial and intraorbital tumors.[13]
  • 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 withNF-1, as compared to patients without NF-1.[14][15][16]
Prognosis Age at onset Clinical features Radiographic features
Favorable prognosis
 Early childhood to adolescence
  • Visual loss with laterality
  • Slowly progressive or arrested course
  • Incidental finding in child with neurofibromatosis
  • No symptoms of endocrine dysfunction or hydrocephalus
  • Does not have diencephalic syndrome
  • Intrinsic optic nerve and/or chiasmal location
Poor Prognosis
 Infancy to early childhood and adulthood
  • Hypothalamic symptoms and/or signs of increased intracranial pressure
  • Severely affected vision in both eyes
  • Large exophytic chiasmal tumor with posterior extension
  • Extension into third ventricle
  • Hydrocephalus

References

  1. ↑ Schupper A, Kornreich L, Yaniv I, Cohen IJ, Shuper A (2009). "Optic-pathway glioma: natural history demonstrated by a new empirical score". Pediatr Neurol. 40 (6): 432–6. doi:10.1016/j.pediatrneurol.2008.12.015. PMID 19433276.
  2. ↑ Parsa CF, Hoyt CS, Lesser RL, Weinstein JM, Strother CM, Muci-Mendoza R; et al. (2001). "Spontaneous regression of optic gliomas: thirteen cases documented by serial neuroimaging". Arch Ophthalmol. 119 (4): 516–29. PMID 11296017.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ Optic nerve glioma. Radiopedia(2015) http://radiopaedia.org/articles/optic-nerve-glioma Accessed on October 5 2015
  6. ↑ 6.0 6.1 Optic glioma. Medline Plus(2015) https://www.nlm.nih.gov/medlineplus/ency/article/001024.htm Accessed on October 5 2015
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ Gibberd FB, Miller TN, Morgan AD (1973). "Glioblastoma of the optic chiasm". Br J Ophthalmol. 57 (10): 788–91. PMC 1215165. PMID 4361475.
  10. ↑ Hoyt WF, Meshel LG, Lessell S, Schatz NJ, Suckling RD (1973). "Malignant optic glioma of adulthood". Brain. 96 (1): 121–32. PMID 4695718.
  11. ↑ 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.
  12. ↑ 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.
  13. ↑ 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.
  14. ↑ 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.
  15. ↑ 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.
  16. ↑ 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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