Optic pathway glioma in children

does visual deficit correlate with radiology in focal exophytic lesions?

Kristian Aquilina, David J. Daniels, Helen Spoudeas, Kim Phipps, Hoong Wei Gan, Frederick Boop

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: Unlike pilocytic astrocytomas in other parts of the brain, optic pathway gliomas (OPG) are usually diffuse lesions involving the anterior optic pathways and hypothalamus. Their infiltrative nature often precludes complete surgical resection. We sought to determine whether careful magnetic resonance (MR) analysis, correlated with visual deficits, could be sufficient to identify those focal lesions that may be amenable to more aggressive surgical resection at presentation. Methods: We retrospectively reviewed the medical records of patients from two sites: children under 20 years of age treated for OPG between 1985 and 2009 at St Jude’s Children’s Research Hospital and children under 16 years of age treated at Great Ormond Street Hospital, London, UK, between 1984 and 2011. Patients with isolated optic nerve tumors were excluded. Visual acuity and visual field data at presentation were reviewed and correlated with MR characteristics, including extent of optic pathway involvement, symmetry, and lateral extension. Results: Two hundred and one children were treated for OPG between 1984 and 2011 in the two institutions; 74 had neurofibromatosis 1 (NF1). At presentation, visual loss was symmetrical in 132 patients and asymmetrical in 69. Potential correlation between pattern of visual loss and tumor characteristics on routine MRI was found in only 13 patients with asymmetrical vision. There was no difference between patients with and without NF1. Conclusion: The decision for aggressive surgical resection for optic pathway gliomas should be based on clinical criteria, particularly in children with good vision in one eye and poor vision in the other, as current MRI results do not reliably predict visual field deficits.

Original languageEnglish (US)
Pages (from-to)2041-2049
Number of pages9
JournalChild's Nervous System
Volume31
Issue number11
DOIs
StatePublished - Nov 1 2015

Fingerprint

Optic Nerve Glioma
Radiology
Neurofibromatosis 1
Visual Fields
Magnetic Resonance Spectroscopy
Astrocytoma
Optic Nerve
Hypothalamus
Visual Acuity
Medical Records
Neoplasms
Brain
Research

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Optic pathway glioma in children : does visual deficit correlate with radiology in focal exophytic lesions? / Aquilina, Kristian; Daniels, David J.; Spoudeas, Helen; Phipps, Kim; Gan, Hoong Wei; Boop, Frederick.

In: Child's Nervous System, Vol. 31, No. 11, 01.11.2015, p. 2041-2049.

Research output: Contribution to journalArticle

Aquilina, Kristian ; Daniels, David J. ; Spoudeas, Helen ; Phipps, Kim ; Gan, Hoong Wei ; Boop, Frederick. / Optic pathway glioma in children : does visual deficit correlate with radiology in focal exophytic lesions?. In: Child's Nervous System. 2015 ; Vol. 31, No. 11. pp. 2041-2049.
@article{3b7378d4ff854a79960f8e4cfb9fabef,
title = "Optic pathway glioma in children: does visual deficit correlate with radiology in focal exophytic lesions?",
abstract = "Purpose: Unlike pilocytic astrocytomas in other parts of the brain, optic pathway gliomas (OPG) are usually diffuse lesions involving the anterior optic pathways and hypothalamus. Their infiltrative nature often precludes complete surgical resection. We sought to determine whether careful magnetic resonance (MR) analysis, correlated with visual deficits, could be sufficient to identify those focal lesions that may be amenable to more aggressive surgical resection at presentation. Methods: We retrospectively reviewed the medical records of patients from two sites: children under 20 years of age treated for OPG between 1985 and 2009 at St Jude’s Children’s Research Hospital and children under 16 years of age treated at Great Ormond Street Hospital, London, UK, between 1984 and 2011. Patients with isolated optic nerve tumors were excluded. Visual acuity and visual field data at presentation were reviewed and correlated with MR characteristics, including extent of optic pathway involvement, symmetry, and lateral extension. Results: Two hundred and one children were treated for OPG between 1984 and 2011 in the two institutions; 74 had neurofibromatosis 1 (NF1). At presentation, visual loss was symmetrical in 132 patients and asymmetrical in 69. Potential correlation between pattern of visual loss and tumor characteristics on routine MRI was found in only 13 patients with asymmetrical vision. There was no difference between patients with and without NF1. Conclusion: The decision for aggressive surgical resection for optic pathway gliomas should be based on clinical criteria, particularly in children with good vision in one eye and poor vision in the other, as current MRI results do not reliably predict visual field deficits.",
author = "Kristian Aquilina and Daniels, {David J.} and Helen Spoudeas and Kim Phipps and Gan, {Hoong Wei} and Frederick Boop",
year = "2015",
month = "11",
day = "1",
doi = "10.1007/s00381-015-2855-7",
language = "English (US)",
volume = "31",
pages = "2041--2049",
journal = "Child's Nervous System",
issn = "0256-7040",
publisher = "Springer Verlag",
number = "11",

}

TY - JOUR

T1 - Optic pathway glioma in children

T2 - does visual deficit correlate with radiology in focal exophytic lesions?

AU - Aquilina, Kristian

AU - Daniels, David J.

AU - Spoudeas, Helen

AU - Phipps, Kim

AU - Gan, Hoong Wei

AU - Boop, Frederick

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Purpose: Unlike pilocytic astrocytomas in other parts of the brain, optic pathway gliomas (OPG) are usually diffuse lesions involving the anterior optic pathways and hypothalamus. Their infiltrative nature often precludes complete surgical resection. We sought to determine whether careful magnetic resonance (MR) analysis, correlated with visual deficits, could be sufficient to identify those focal lesions that may be amenable to more aggressive surgical resection at presentation. Methods: We retrospectively reviewed the medical records of patients from two sites: children under 20 years of age treated for OPG between 1985 and 2009 at St Jude’s Children’s Research Hospital and children under 16 years of age treated at Great Ormond Street Hospital, London, UK, between 1984 and 2011. Patients with isolated optic nerve tumors were excluded. Visual acuity and visual field data at presentation were reviewed and correlated with MR characteristics, including extent of optic pathway involvement, symmetry, and lateral extension. Results: Two hundred and one children were treated for OPG between 1984 and 2011 in the two institutions; 74 had neurofibromatosis 1 (NF1). At presentation, visual loss was symmetrical in 132 patients and asymmetrical in 69. Potential correlation between pattern of visual loss and tumor characteristics on routine MRI was found in only 13 patients with asymmetrical vision. There was no difference between patients with and without NF1. Conclusion: The decision for aggressive surgical resection for optic pathway gliomas should be based on clinical criteria, particularly in children with good vision in one eye and poor vision in the other, as current MRI results do not reliably predict visual field deficits.

AB - Purpose: Unlike pilocytic astrocytomas in other parts of the brain, optic pathway gliomas (OPG) are usually diffuse lesions involving the anterior optic pathways and hypothalamus. Their infiltrative nature often precludes complete surgical resection. We sought to determine whether careful magnetic resonance (MR) analysis, correlated with visual deficits, could be sufficient to identify those focal lesions that may be amenable to more aggressive surgical resection at presentation. Methods: We retrospectively reviewed the medical records of patients from two sites: children under 20 years of age treated for OPG between 1985 and 2009 at St Jude’s Children’s Research Hospital and children under 16 years of age treated at Great Ormond Street Hospital, London, UK, between 1984 and 2011. Patients with isolated optic nerve tumors were excluded. Visual acuity and visual field data at presentation were reviewed and correlated with MR characteristics, including extent of optic pathway involvement, symmetry, and lateral extension. Results: Two hundred and one children were treated for OPG between 1984 and 2011 in the two institutions; 74 had neurofibromatosis 1 (NF1). At presentation, visual loss was symmetrical in 132 patients and asymmetrical in 69. Potential correlation between pattern of visual loss and tumor characteristics on routine MRI was found in only 13 patients with asymmetrical vision. There was no difference between patients with and without NF1. Conclusion: The decision for aggressive surgical resection for optic pathway gliomas should be based on clinical criteria, particularly in children with good vision in one eye and poor vision in the other, as current MRI results do not reliably predict visual field deficits.

UR - http://www.scopus.com/inward/record.url?scp=84945469591&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945469591&partnerID=8YFLogxK

U2 - 10.1007/s00381-015-2855-7

DO - 10.1007/s00381-015-2855-7

M3 - Article

VL - 31

SP - 2041

EP - 2049

JO - Child's Nervous System

JF - Child's Nervous System

SN - 0256-7040

IS - 11

ER -