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Optic nerve sheath meningiomas: visual improvement after stereotactic radiotherapy
James K Liu1, Scott Forman, Gerard L Hershewe
1Department of Neurosurgery, New York Medical College, Valhalla, New York 10595, USA.
Neurosurgery
|April 13, 2002
Summary
Stereotactic radiotherapy (SRT) offers a promising treatment for optic nerve sheath meningioma (ONSM), potentially improving or stabilizing vision without disease progression. This approach may be a viable alternative for patients experiencing visual deterioration.
Area of Science:
- Ophthalmology
- Neurosurgery
- Radiation Oncology
Background:
- Optic nerve sheath meningioma (ONSM) management is challenging, with surgery risking blindness and untreated tumors causing progressive visual loss.
- Stereotactic radiotherapy (SRT) is a less-explored but potentially effective treatment for rare ONSMs.
Observation:
- Five patients with progressive visual loss due to ONSM were treated with SRT.
- Tumor locations varied, including intraorbital, intracanalicular, and intracranial extensions.
- Functional vision was present in five eyes prior to treatment.
Findings:
- Serial imaging showed no tumor size changes in any patient after SRT.
- Four patients experienced significant visual improvement (acuity, field, color vision) within 3 months.
- One patient remained stable, with no visual deterioration or radiation-induced optic neuropathy.
Implications:
- SRT may be a viable treatment option for primary ONSM, especially in cases of documented visual decline.
- This technique shows potential for preserving or enhancing vision in affected individuals.
- Further research into SRT for ONSM could refine treatment protocols and improve patient outcomes.