May be a loss of peripheral vision, or vision loss may be more general
The child may show symptoms of diencephalic syndrome, which includes:
Decreased memory and brain function
Loss of appetite and body fat
Signs and tests
A brain and nervous system (neurologic) examination reveals a loss of vision in one or both eyes. There may be changes in the optic nerve, including swelling or scarring of the nerve, or paleness and damage to the optic disc.
The tumor may extend into deeper parts of the brain. There may be signs of increased pressure in the brain (intracranial pressure). There may be signs of neurofibromatosis type 1 (NF1).
Treatment varies with the size of the tumor and the general health of the person. The goal may be to cure the disorder, relieve symptoms, or improve vision and comfort.
Surgery to remove the tumor may cure some optic gliomas. Partial removal to reduce the size of the tumor can be done in many cases. This will keep the tumor from damaging normal brain tissue around it.
Radiation therapy may be recommended in some cases where the tumor is larger and surgery is not possible. In some cases, radiation therapy may be delayed because the tumor is slow growing.
Corticosteroids may be prescribed to reduce swelling and inflammation during radiation therapy, or if symptoms return.
Chemotherapy may be used in some children. Chemotherapy may be especially useful when the tumor extends into the hypothalamus.
The outlook is highly variable. Early treatment improves the chance of a good outcome. Many tumors are curable with surgery, while others return.
Normally, the growth of the tumor is very slow, and the condition remains stable for long periods of time. However, in adults and some childhood cases where the optic chiasm is involved, the tumor behaves aggressively.
Olitsky SE, Hug D, Plummer LS, Strass-Isern M. Abnormalities of the optic nerve. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 623.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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