Optic Nerve Glioma

Optic nerve glioma are most often pilocytic astrocytoma (WHO grade I). They usually occur in early childhood and are located along the optic nerve.

Histology of Optic Nerve Glioma

  • usually slowly growing tumour (pilocytic astrocytoma WHO grade I

 

Epidemiology of Optic Nerve Glioma

      • 80% occur in first decade of life
      • very rarely occur in adulthood
      • neurofibromatosis type I as known risk factor

           

          Symptoms of Optic Nerve Glioma

              • decrease of vision and restriction of visual field
              • in serious cases loss of sight
              • protuberance of the eye
              • intracranial pressure (headache, emesis, vomiting)
              • possible that there are no symptoms

                   

                  Diagnosing Optic Nerve Glioma

                    • neurological examination as well as CT/MRI
                    • ophthalmological examination
                    • clearly defined lesion, often heterogeneous
                    • enhancement of contrast agent
                    • frequently cysts
                    • growing along optic nerve, chiasma and hypothalamus


                        Therapy of Optic Nerve Glioma

                          • no standard therapy
                          • if possible surgical removal; mostly partial removal
                          • if tumour is inoperable: biopsy for diagnostic confirmation
                          • if tumour can´t be removed or only partially: chemotherapy or radiotherapy
                          • possibly radiosurgery
                          • possibly immunotherapy

                             

                            Therapy of Recurrent Optic Nerve Glioma

                                • possibly (re-)operation
                                • possibly chemo- or radiotherapy

                                     

                                    Aftercare of Optic Nerve Glioma

                                        • first every 3 months
                                        • after one year every 6 to 12 months
                                        • MRI wih contrast agent as method of choice

                                             

                                            Course of Optic Nerve Glioma

                                              • spontaneous regressions are possible
                                              • inoperable and partially removed tumours can be constant over years

                                                 

                                                Prognosis of Optic Nerve Glioma

                                                    • depending on extend of surgery
                                                    • complete surgical removal equates with a cure

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