title: Ophthalmologic findings and long-term course in patients with neurofibromatosis type 2.
abstract: OBJECTIVE
  To evaluate ophthalmologic findings and long-term course in patients with neurofibromatosis type 2 (NF2).
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  
  
  
  METHODS
  Single-center institutional practice.
  
  
  METHODS
  Thirty referred patients with NF2 were enrolled from 1991 to 2003 and underwent at least one thorough neuroophthalmologic examination. Follow-up of 23 patients ranged from 4.3 to 12.5 years.
  
  
  METHODS
  Visual function, structural ocular abnormalities, onset and type of presenting NF2-related symptoms, and number of central nervous system tumors.
  
  
  RESULTS
  Initial symptoms for patients with early-onset NF2 mostly comprised ophthalmologic symptoms (n = 7) and lower motor neuron extremity weakness (n = 6), as opposed to eighth nerve impairment (n = 11) in late disease onset. NF2-specific ocular findings were noted in 83% of all patients (94% childhood onset; 67% adult onset): 67% had cataracts, 40% epiretinal membranes, 3% hamartoma, 13% disk gliomas, and 27% optic nerve sheath meningiomas. Only 14% in the childhood-onset group-as opposed to 78% in the adult-onset group-sustained visual acuity of 1.0 in both eyes at final examination. Significantly more patients with early onset of symptoms developed multiple central nervous system tumors (P = .004) and showed a higher amount of NF2-specific findings (P = .015).
  
  
  CONCLUSIONS
  Initial manifestations of NF2 differ between children and adults. NF2-specific ophthalmologic findings can help establish the diagnosis. Symptom onset at a young age is clearly a risk factor for marked disease progression. These patients should be carefully followed because survival rates have increased, and vision becomes increasingly important as the disease progresses.
authors.affiliation: Department of Ophthalmology, University Hospital Zürich, Switzerland.
authors.forename: Martina M
authors.initials: MM
authors.lastname: Bosch
authors.forename: Eugen
authors.initials: E
authors.lastname: Boltshauser
authors.forename: Paul
authors.initials: P
authors.lastname: Harpes
authors.forename: Klara
authors.initials: K
authors.lastname: Landau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018450:Disease Progression; D005128:Eye Diseases / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016518:Neurofibromatosis 2 / Q000175:diagnosis* / Q000503:physiopathology; D010641:Phenotype; D012189:Retrospective Studies; D014792:Visual Acuity