Review
Eye (2006) 20, 1149–1164. doi:10.1038/sj.eye.6702379
Optic glioma warranting treatment in children
This work was presented at the Thirty-fifth Cambridge Ophthalmological Symposium; The Orbit, September 2005
The authors have no proprietary interest in any devises or procedures herein mentioned
1Department of Ophthalmology and Visual Sciences, Section of Pediatric Ophthalmology and Adult Strabismus, University of Illinois at Chicago, Chicago, IL, USA
Correspondence: LM Kaufman, Department of Ophthalmology and Visual Sciences, Section of Pediatric Ophthalmology and Adult Strabismus, University of Illinois at Chicago, 1855 West Taylor Street, Chicago, IL 60612, USA. Tel: +1 312 996 9122; Fax: +1 312 413 4916. E-mail: idoc00@sbcglobal.net
Abstract
Purpose
To describe cases of optic pathway glioma (OPG) warranting treatment in children.
Methods
This is a retrospective review of pediatric patients treated for OPG. The clinical data and imaging studies were obtained from the medical records and radiology files of patients seen at the Pediatric Neuro-Ophthalmology Clinic at the University of Illinois, Chicago and the private office of the author (LMK).
Results
A total of seven cases with an age range of 3–48 months at presentation were reviewed. Three of the patients were also ultimately diagnosed with neurofibromatosis type 1. Presenting symptoms included proptosis, decreased vision, gaze deficit, and nystagmus. Four patients underwent biopsies that confirmed OPG. Six of the patients were treated with intravenous chemotherapy, with three patients requiring a second chemotherapy cycle. One patient was successfully treated with an en-bloc optic nerve excision. Two patients underwent unilateral enucleation owing to globe complications.
Conclusion
Although benign tumours, OPG can behave very aggressively in young children. Both chemotherapy and en-bloc excision can be employed for treatment.
Keywords:
optic pathway glioma, juvenile pilocytic astrocytoma, childhood, treatment, chemotherapy
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