Orbital Tumors - Optic Nerve Glioma
-
Clinical Symptoms
- decreased visual acuity
- minimal proptosis
- restricted, decreased eye movement
- strabismus
-
Etiology
- neoplasm of {the} optic nerve
- may also be called juvenile pilocytic astrocytoma
- Optic nerve glioma in adults are glioblastoma
- Optic nerve glioma is {the} most common cause of optic nerve enlargement
- it accounts for 80% of optic nerve tumors
- 1% of all intracranial tumors
- 2% of childhood intraorbital masses
-
Demographics
- 80% are in children under 10 years old
- peak age is 5-8
- 90% of patients are under {the} age of 20
- more common in females
- 10-50% are in neurofibromatosis patients, especially if bilateral
- 15% of NF patients have an optic glioma
-
Clinical Course
- Optic nerve gliomas grow very slowly and have similar pathology as juvenile pilocytic astrocytomas of {the} cerebellum.
- typically intraorbitally and grow in a fusiform shape
- 25% are limited to {the} orbit
- malignant degeneration is very rare in children
- if {the} tumor begins in {the} chiasm, it is likely to invade surrounding parenchyma regardless of age
-
Imaging
- On MRI, there is usually mild contrast enhancement. The affected optic nerve should be greater than 3 mm in diameter, or 1 mm wider than {the} unaffected side. It should be hypo- to isointense to muscle on T1 and hyperintense on T2. Fat supression sequences should be performed to see {the} entire extent of {the} lesion since it may possibly appear to be more extensive than it is on T2-weighted images secondary to edema
-
Differential Diagnosis
- Sarcoidosis
- Infiltration by leukemia or lymphoma
- Optic neuritis
- Perineural hematoma
- Papilledema of intracranial hypertension
- Patulous subarachnoid space
Procedures
- Home
- Anophthalmos
- Blepharoplasty
- Blepharospasm
- Brow Lift
- Congenital
- Dry Eye
- Eyelid Laxity
- Face
- Infections
- Inflammation
- Lacrimal System
- Lagophthalmos
- Latisse
- Locate an MD
- Orbital Tumors
- Ptosis
- Skin Rejuvenation
- Skin Tumors
- Symblepharon
- Thyroid
- Trauma