Gliomas of the optic nerve are relatively uncommon. We have experienced one case of glioma of the optic nerve recently. The patient was 17 year old boy who had exophthalmos and visual disturbance in his left eye for three years. The vision was CF/30cm. in his left eye and the optic nerve head was extremely atrophic. The eyeball was displaced infero-temporally. The exophthalmic value was 14mm. in right and 18mm. in left eye. On July 31, 1986, the left eyeball was exposed through Kroenlein method and the tumor mass was excised totally but the eyeball remained intact. The gross appearance of the tumor was large fusiform shape(3.5 X 2.0 X 1.8cm.) with well encapsulated grayish-white surface. The cut-section of the tumor revealed grayish-white solid area and hemorrhagic cystic area. The histopathologic slides showed that the tumor was composed of multiple pilocytic astrocytic cells in the solid area and in microcystic area. The cytoplasm of the tumor cells were bipolar spindle shape and the nucleus was uniform in general and there was no sign of mitotic figure. Numerous dense and amorphous eosinophilic materials so called "Rosenthal fibers" were also seen in the microcystic areas. Finally we have diagnosed this tumor as the Optic nerve glioma.
Adolescent ; Cytoplasm ; Eosinophils ; Exophthalmos ; Glioma ; Humans ; Male ; Optic Disk ; Optic Nerve Glioma* ; Optic Nerve*

Optic nerve gliomas are uncommon, and they and derived from altrocyte or oligodendrocyte of the optic nerve. The peak incidence is from 2 to 6 years of age. In most cases, prognosis is good and it is usually developed unilaterally. Occasionally it involves bilateral optic nerve and then usually associated with neurofibrotnatosis. Among reports of optic nerve gliomas, the incidence of neurofibromatosis varies from 12% to 38%. We have experienced of a case of bilateral optic nerve glioma not associated with neurofibromatosis in a 6 year old female patient. So the literature of the optic nerve gliomas was briefly reviewed with clinical study.
Child ; Female ; Humans ; Incidence ; Neurofibromatoses ; Oligodendroglia ; Optic Nerve Glioma* ; Optic Nerve* ; Prognosis

A twenty nine-year-old woman has suffered for ten years from progressive proptosis and loss of vision in the right eye. Her right eye had deviated out-and-upwards, and its visual acuity was tested by hand motions. With the help of a brain and orbit CT, the tumor was found around the optic nerve and in the parasellar area. This tumor was surgically removed twice by Kroenlein operation and craniotomy, and was treated with irradiation(total dose: 5400 RAD). It was histopathologically diagnosed as astracytoma grade I. In the consecutive study, no evidence of recurrence of the tumor in either the orbit or brain was found.
Brain ; Craniotomy ; Exophthalmos ; Female ; Hand ; Humans ; Optic Chiasm* ; Optic Nerve Glioma* ; Optic Nerve* ; Orbit ; Recurrence ; Visual Acuity

A case of optic nerve glioma is presented. This 11 years old Korean boy was seen because of proto nasion of the risht eye ball of 2 months duration. Vision of the right eye was reduced to 20/30 and optic disc showed blurring of the margin with some venous engorgement. Visual field showed enlarged blind spot of Mariotte and contraction of temporal field of vision in the right eye. Radiograpic study of the optic foramina was normal. There was no cafe-au-lait spot. On April 19. 1967. the orbit was exposed through anterior approach because of the tumor possibly invading the intraocular pertion. On operating procedure it was easy to remove the tumor and optic nerve by aspiration of 3 cc. of vitreous using 19 gauge needle. We confirmed a diagnosis of astrocytoma of the optic nerve in pathologic study. A year later the removal of the tumor, the patient was in good health and there had been no recurrence. A review of the literature of recent years related to glioma of the optic nerve, particularly its signs, symptoms, diagnosis and treatment was added.
Astrocytoma ; Cafe-au-Lait Spots ; Child ; Diagnosis ; Glioma ; Humans ; Hyperemia ; Male ; Needles ; Optic Disk ; Optic Nerve Glioma* ; Optic Nerve* ; Orbit ; Recurrence ; Visual Fields

PURPOSE: To report a case of optic neuritis difficult to differentiate from ischemic optic neuropathy and optic nerve glioma. CASE SUMMARY: A 63-year-old male visited our clinic because of a sudden painless decrease in visual acuity in his right eye. He had a relative afferent pupillary defect and inferior altitudinal scotoma with disc pallor in his right eye. Ischemic optic neuropathy was suspected based on these clinical observations. However, a focal enhancing lesion was found in the intracranial portion of the right optic nerve on gadolinium-enhanced T1-weighted MRI. The radiologist's report revealed right intracranial optic glioma. Optic neurectomy was planned in accordance with the suspicion for optic glioma. However, a systemic mega-dose methylprednisolone therapy which is relatively less invasive was performed first based on the decision that optic neuritis should be distinguished from optic nerve glioma. The patient was hospitalized and 1 gram of methylprednisolone was injected intravenously daily for 3 days. The patient's visual acuity in the right eye improved from 0.1 before treatment to 0.3 after treatment. MRI scans at 8 months after steroid treatment showed disappearance of the previously enhanced lesion suspicious for optic glioma with developed atrophic change. The patient was finally diagnosed with optic neuritis based on these results. CONCLUSIONS: Careful differential diagnoses and therapeutic approaches to possible diseases are necessary because optic neuritis can manifest as a variety of clinical entities and imaging findings.
Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Methylprednisolone ; Middle Aged ; Optic Nerve ; Optic Nerve Glioma* ; Optic Neuritis* ; Optic Neuropathy, Ischemic* ; Pallor ; Pupil Disorders ; Scotoma ; Visual Acuity

OBJECTIVE: Compared with other neural structures, optic apparatus are particularly sensitive to radiation. If tumors are adjacent to or in contact with optic apparatus, a number of limitations need to be addressed for planning radiosurgery. To avoid radiation induced optic neuropathy, we treated these lesions with fractionated stereotactic radiosurgery (FSRS). This study is undertaken to assess the efficacy of FSRS for sella and parasella tumors adjacent to or in contact with optic apparatus. METHODS: We treated 19 sellar region tumors located adjacent to or in contact with optic apparatus with fractionated stereotactic radiosurgery using the Novalis system. Seventeen patients who could be followed were included in this study. They consisted of 8 pituitary adenomas, 4 optic gliomas, 3 meningiomas, 2 craniopharyngiomas. The mean tumor volume was 16.1cc(range 1-61.1). When planning FSRS, the prescribed fractionation dose to optic apparatus below 200cGy. Follow up examinations consisted of neurological, neuroradiological, and neuroopthalmological evaluations. RESULTS: Follow-up ranged from 2 to 34 months(mean 15 months). Serial magnetic resonance imaging revealed no increase in volume of tumor in all 17 patients. No patients had radiation induced optic neuropathy. CONCLUSION: Fractionated stereotactic radiosurgery is proper innovative treatment modality for sella or parasella tumors adjacent to or in contact with optic apparatus to avoid radiation induced optic neuropathy. We need further follow-up and clinical experiences.
Craniopharyngioma ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Meningioma ; Optic Nerve Diseases ; Optic Nerve Glioma ; Pituitary Neoplasms ; Radiosurgery ; Tumor Burden

Neurofibromatosis type 1(NF1) is one of the most common inherited disorders, clinically characterized by cafe-au-lait spots, Lisch nodules and neurofibromas. In addition, the affected individuals usually develop benign and malignant tumors of the nervous system. One of the most common tumors is the optic nerve glioma. NF1-associated glioma, however, rarely occurs in the cerebellum. Recently, we experienced a NF1-associated cerebellar pilocytic astrocytoma in an 11 years old girl. She has a family history of NF1 and multiple cafe-au-lait spots over her whole body. We report herewith a case of NF1-associated cerebellar pilocytic astrocytoma with a brief review of related literature.
Astrocytoma* ; Cafe-au-Lait Spots ; Cerebellum ; Child ; Female ; Glioma ; Humans ; Nervous System Neoplasms ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1* ; Optic Nerve Glioma

A 57 year old male, complaining of exophthalmos, disturbance of ocular motility and visual acuity in the right eye, was admitted under the disgnosis of orbital tumor. The tumor was removed by Kronlein procedure and verified as glioma microscopically. The following seven months period of postoperative observations revealed degenerative changes in the retina, atrophy of the optic nerve and enophthalmos in the affected side but no signs of recurrence.
Atrophy ; Enophthalmos ; Exophthalmos ; Glioma* ; Humans ; Male ; Middle Aged ; Optic Nerve ; Orbit* ; Recurrence ; Retina ; Visual Acuity

PURPOSE: To evaluate the MR findings of optic chiasmatic glioma (OCG). MATERIALS AND METHODS: MR images were reviewed in 14 patients with histologically proven OCGs and one with neurofibromatosis type 1 (male: female=8:7, mean age=8.5 years). Tumors were evaluated retrospectively with respect to their size, involvement of the optic pathway, transverse/vertical diameter ratio based on the coronal plane, signal intensities, enhancement pattern, and the presence of a cyst or calcification. RESULTS: Tumors was measured 1.7-5.5 (mean, 3.3) cm in maximum diameter. In ten patients, the optic tracts were involved, and in three, the optic nerves. In 12 patients, tumors had a transverse/vertical diameter ratio of over one, and showed iso (n=5) or low signal intensity (n= 10) compared with gray matter at T1-weighted imaging and high signal intensity (n=15) at T2-weighted imaging. Cyst formations were seen in eight patients, and tumors were enhanced strongly and homogeneously in nine and peripherally in four. In seven there was associated hydrocephalus, and in one, calcification. CONCLUSION: OCG is a suprasellar tumor which can extend into the optic pathway, has a transverse/vertical diameter ratio of more than one, and shows strong and homogeneous enhancement. These MR imaging findings are useful for the differentiation of OCG from other suprasellar tumors.
Glioma* ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Neurofibromatosis 1 ; Optic Nerve ; Retrospective Studies ; Visual Pathways

OBJECTIVE: To investigate the effect of bevacizumab in the treatment of children with optic pathway glioma (OPG). METHODS: A retrospective analysis was performed for the clinical data of 30 children with OPG who underwent chemotherapy. According to whether bevacizumab was used, they were divided into conventional chemotherapy (carboplatin, vincristine and etoposide) group with 12 children and combined chemotherapy (bevacizumab, carboplatin, vincristine and etoposide) group with 18 children. The children were followed up to 6 months after chemotherapy, and the two groups were compared in terms of visual acuity and tumor size before and after chemotherapy and adverse reactions during chemotherapy. RESULTS: The combined chemotherapy group had a significantly higher proportion of children achieving tumor regression than the conventional chemotherapy group (P<0.05), while there were no significant differences between the two groups in the proportion of children with improved visual acuity or adverse reactions (P>0.05). No chemotherapy-related death was observed in either group. CONCLUSIONS Bevacizumab combined with conventional chemotherapy can effectively reduce tumor size. Compared with conventional chemotherapy, such combination does not increase adverse reactions and can thus become a new direction for the treatment of OPG in children.
Antineoplastic Combined Chemotherapy Protocols ; Bevacizumab ; Carboplatin ; Child ; Humans ; Optic Nerve Glioma ; Retrospective Studies ; Vincristine