Optic Nerve Hemangioblastomas?A Review of Visual Outcomes

Supratentorial hemangioblastomas (HBLs) are exceedingly uncommon. They account for less than 5% of all central nervous system HBLs. The commonest location is the cerebral cortex. Rarely, they can involve the visual pathway. Most of the reports have focused on the differential diagnosis, since depending on the location they can often resemble optic nerve gliomas or meningiomas of the optic nerve sheath. In this study, we describe a 67-year-old man with progressive diminution of vision in the left eye with an optic nerve hemangioblastoma. There was no history of von Hippel-Lindau disease. We discuss the diagnostic challenges, and review the visual presentation and visual outcomes in these patients. This report, we believe, may add further clarity in counseling patients with an optic nerve lesion and the factors in surgical decision-making.