Long-term outcome in children with gliomas of the anterior visual pathway.

Full Abstract

We performed a retrospective assessment of the long-term visual, neurologic, and systemic outcomes of 47 patients with anterior visual pathway gliomas seen at the Johns Hopkins Hospital. All of the patients had follow-up of at least 10 years or died during the follow-up period. Two patients died before 10 years of follow-up were achieved. The remaining 45 patients (including three patients who subsequently died) had follow-up of 10-28 years (mean, 15.3 years; median, 15 years). Sixteen of the patients in this study, most of whom had neurofibromatosis type 1 (NF1), received no treatment. None of these patients died or developed neurologic morbidity as a result of their tumor. Thirty-one of the patients, most of whom did not have evidence of NF1, received treatment. Many of these patients subsequently developed neurologic, endocrine, or visual morbidity. However, although patients with anterior visual pathway gliomas who were not treated fared better visually, neurologically, and systemically than patients who were treated, patients who required treatment for progression generally had a good overall prognosis, particularly patients with tumors that did not involve the hypothalamus. Most of these patients survived and maintained useful vision in at least one eye. We believe that patients with anterior visual pathway gliomas, particularly those with NF1, should not be treated unless there is clear clinical or neuroimaging evidence of progression.

Author information

Author/s: Tow, Sharon L (SL); Chandela, Sidhartha (S); Miller, Neil R (NR); Avellino, Anthony M (AM);

Affiliation: Neuro-Ophthalmology Unit, Wilmer Eye Institute, the Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Pediatric neurology (Pediatr Neurol), published in United States. (Language: eng)

Reference: 2003-Apr; vol 28 (issue 4) : pp 262-70

Dates: Created 2003/07/09; Completed 2003/12/09; Revised 2006/11/15;

PMID: 12849878, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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