Current treatment of optic nerve gliomas

Farazdaghi, Marybeth K; Katowitz, William R.; Avery, Robert A.

doi:10.1097/icu.0000000000000587

Cited by 61 publications

(51 citation statements)

References 117 publications

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“… 2 OPGs affect the intraorbital optic nerve in 25% of cases. 1 Lesions may be associated with systemic neurofibromatosis type 1, but also occur sporadically, with sporadic lesions portending a higher rate of chiasmal progression. 1 These lesions typically induce painless axial globe proptosis, progressive vision loss and clinical stigmata of compressive optic neuropathy.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Lesions may be associated with systemic neurofibromatosis type 1, but also occur sporadically, with sporadic lesions portending a higher rate of chiasmal progression. 1 These lesions typically induce painless axial globe proptosis, progressive vision loss and clinical stigmata of compressive optic neuropathy. The patient herein instead presented with sudden vision change and an edematous optic nerve with adjacent subretinal fluid, favoring an acute process.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, targeted therapy with mitogen-activated protein (MAP) kinase pathway inhibitors and systemic anti -VEGF have been successfully trialed. 1 Optic canal decompression has resulted in improved vision in select cases. 4 Surgical enucleation is often reserved for intracranial or intracanalicular involvement, or for painful and/or disfiguring proptosis in low-vision eyes.…”

Section: Discussionmentioning

confidence: 99%

“…Optic pathway gliomas (OPG) most commonly present in the pediatric patient population with painless proptosis, slowly progressive vision loss, and clinical findings of chronic optic neuropathy. 1 Acute presentations of this disease in adulthood are rare.…”

Section: Introductionmentioning

confidence: 99%

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Acute post-partum vision loss due to pilocytic astrocytoma

Homer¹,

Epstein²,

Durairaj

et al. 2020

American Journal of Ophthalmology Case Reports

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Purpose We report an unusual case of a thirty-three-year-old woman who presented with acute unilateral vision loss following pregnancy and was ultimately discovered to have a pilocytic astrocytoma of the optic nerve. Observations A thirty-three-year-old previously healthy female presented one month following Caesarean section with unilateral vision loss. She was found to have significantly decreased visual acuity, an afferent pupil deficit, proptosis, optic nerve edema and choroidal folds. Imaging revealed a large lesion of the optic nerve. Biopsy was performed and pathologic analysis revealed a pilocytic astrocytoma, WHO grade 1. The patient opted for close observation without further management and demonstrated mild improvement in visual function. Conclusions/Importance Optic pathway gliomas (OPG) most commonly present in the pediatric patient population with painless proptosis, slowly progressive vision loss, and clinical findings of chronic optic neuropathy.( Farazdaghi et al., 2019 Sep) 1 Acute presentations of this disease in adulthood are rare. This case demonstrates a rare case of acute optic nerve glioma presentation during the post-partum period.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute post-partum vision loss due to pilocytic astrocytoma

Homer¹,

Epstein²,

Durairaj

et al. 2020

American Journal of Ophthalmology Case Reports

View full text Add to dashboard Cite

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“…Chiasmal syndrome is associated with lesions of the optic chiasm, manifesting as various impairments of the visual field such as central scotoma, bitemporal paracentral scotoma, junction scotoma and bitemporal hemianopsia [1]. Pituitary tumors are the most common cause [2], but it may be caused by neurofibromatosis, angioma and glioma [3], and associated with other inflammatory diseases such as hypophysitis, chiasmal neuritis, and multiple sclerosis [4].…”

Section: Introductionmentioning

confidence: 99%

Sudden bilateral vision loss due to third ventricular cavernous angioma with intratumoral hemorrhage - case report

Ishijima

Shinmei

Nozaki³

et al. 2019

BMC Ophthalmol

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BackgroundWe report a rare case of sudden bilateral vision loss due to third ventricular cavernous angioma with intratumoral hemorrhage.Case presentationA 45-year-old woman presented decreased visual acuity in both eyes. Her best corrected visual acuity was 0.1 in the right eye and 0.15 in the left eye. Goldmann perimetry showed bilateral central scotomas and bitemporal visual field defects. MRI demonstrated a lesion with mixed hypo- and hyperintensity at the optic chiasm, which was thought to be an intratumoral hemorrhage. The patient underwent bifrontal craniotomy. The tumor was exposed via an anterior interhemispheric approach, and histological evaluation of the mass led to a diagnosis of cavernous angioma. Six months after the surgery, her best corrected visual acuity was 0.9 in the right eye and 0.9 in the left, with slight bitemporal visual field defects.ConclusionThird ventricular cavernous angioma is considered in the differential diagnosis of chiasmal syndrome. Contrast-enhanced MRI and FDG-PET might be useful for differential diagnosis of cavernous angioma from other chiasmal tumors including glioblastoma.

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Neoplasms of the Eye and Orbit

Alvarez¹,

Ponce²,

Chevez‐Barrios³

et al. 2022

Holland‐Frei Cancer Medicine

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Overview Cancers of the eye and orbit are associated with diverse pathological conditions, disease prognosis, and significant mortality. The survival rates vary among patients from different countries and have been reported to be significantly lower in those from developing countries compared to those noted in the United States owing mainly to delay in diagnosis associated with advanced‐stage disease and unavailability of treatments. In this article, we provide an overview of the most common and rare ophthalmic malignancies that include ocular surface, external and adnexal diseases, and orbital and intraocular malignancies. We summarize the incidence, histopathology, risk factors, molecular alterations, clinical presentation, diagnostic evaluation, and therapeutic approaches for these diseases. We also describe the first‐line and salvage treatments and their complications. These treatments depend on disease stage at presentation and include pathology‐guided excision, Mohs microsurgery, chemo‐reduction, chemoprophylaxis, adjuvant chemotherapy after enucleation, and/or neoadjuvant chemotherapy. Complications include symblepharon, scarring, and limbal stem cell deficiency while incomplete excision of eyelid tumors may result in recurrence of larger and more aggressive tumors. Currently, identification of genetic abnormalities identified in genomic profiling of patient tumors improves treatment selection. Early diagnosis and involvement of an ocular oncologist at the time of diagnosis will optimize the therapeutic management of patients with these diseases.

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Current treatment of optic nerve gliomas

Cited by 61 publications

References 117 publications

Acute post-partum vision loss due to pilocytic astrocytoma

Acute post-partum vision loss due to pilocytic astrocytoma

Sudden bilateral vision loss due to third ventricular cavernous angioma with intratumoral hemorrhage - case report

Neoplasms of the Eye and Orbit

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