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Published on: August 4, 2011
Primary optic nerve tumours
1Department für Augenheilkunde, Universität Tübingen, Augenklinik, Tubingen, Germany. helmut.wilhelm@med.uni-tuebingen.de
Purpose Of Review:
Advances have been made in the treatment of primary optic nerve tumours. With a focus on the last few years' publications, recommendations for clinical management are being developed.
Recent Findings:
In low-grade optic nerve glioma, two divergent developments are observed: an increasing reluctance in treating such tumours because of reports about treatment toxicity (secondary tumours, moyamoya syndrome) and a steady and marked improvement both in radiotherapy and chemotherapy. Many reports on beneficial effects of radiotherapy on optic nerve meningioma have been published. Radiotherapy does not only preserve but in many cases even improves or restores visual function and has, therefore, become the therapy of choice in this tumour.
Summary:
Establishing a treatment plan in cases of optic nerve glioma is difficult and must be made on an individual basis. Although both chemotherapy and radiotherapy can stabilize and sometimes improve vision in progressive tumours, chemotherapy is the preferred modality in children younger than 9 years and in patients with neurofibromatosis 1. In functionally progressive optic nerve meningioma with useful visual function, multifractioned stereotactic conformal radiotherapy is the treatment of choice.
Insights
Treatment for optic nerve tumors is advancing, with radiotherapy showing promise for meningiomas and chemotherapy preferred for pediatric gliomas. Management requires individualized plans based on tumor type and patient factors.
Area of Science:
- Ophthalmology
- Neuro-oncology
- Radiation Oncology
Background:
- Primary optic nerve tumors encompass a range of neoplastic conditions affecting the optic nerve.
- Recent advancements focus on refining treatment strategies for optic nerve glioma and meningioma.
Purpose of the Study:
- To review recent publications (last few years) on the treatment of primary optic nerve tumors.
- To develop recommendations for the clinical management of these conditions.
Main Methods:
- Literature review of recent publications on optic nerve tumors.
- Analysis of treatment outcomes for optic nerve glioma and meningioma.
Main Results:
- Low-grade optic nerve glioma management presents divergent approaches due to toxicity concerns versus improved radiotherapy and chemotherapy efficacy.
- Radiotherapy demonstrates significant benefits for optic nerve meningioma, often preserving or improving visual function, establishing it as a preferred treatment.
Conclusions:
- Treatment for optic nerve glioma requires individualized plans, with chemotherapy favored for children under 9 and those with neurofibromatosis 1.
- Multifractionated stereotactic conformal radiotherapy is the treatment of choice for progressive optic nerve meningioma with preserved visual function.
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