title: Optic pathway glioma of childhood.
abstract: OBJECTIVE
  Optic pathway gliomas (OPG) are the most common tumor of the anterior visual pathway and can involve the optic nerve, chiasm, tract, and optic radiations. They are typically benign lesions, often pilocytic astrocytomas, which are diagnosed in childhood. We review the epidemiology, clinical presentation, diagnosis, and management of these lesions in patients with and without neurofibromatosis type 1 (NF-1).
  
  
  RESULTS
  Most commonly, patients diagnosed with OPG have NF-1 especially if the lesions are bilateral. Such lesions tend to have a relatively indolent course and at least 50% of patients have no evidence of visual loss. Rarely, children without NF-1 may sporadically develop OPG with such lesions often having a more aggressive nature and greater propensity for visual dysfunction. The gold standard for diagnosis and follow-up are thorough neuro-ophthalmic examinations with specific attention to visual acuity. Management must be individualized and may comprise conservative follow-up, chemotherapy, radiation and/or surgical intervention.
  
  
  CONCLUSIONS
  OPG may range in their behavior based upon the nature of the tumor (NF-1 or sporadic). Current guidelines recommend following patients with regular clinical examinations. Management of these lesions is highly individualized based upon the nature and extent of the lesion, visual function and side-effect profile of the treatment. Clinicians should be aware of the available options to determine which may be best suited for their patient.
authors.affiliation: Harkness Eye Institute, Columbia University, New York, New York, USA.
authors.forename: Nailyn
authors.initials: N
authors.lastname: Rasool
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Odel
authors.forename: Michael
authors.initials: M
authors.lastname: Kazim
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D008279:Magnetic Resonance Imaging; D009456:Neurofibromatosis 1 / Q000175:diagnosis / Q000628:therapy; D020339:Optic Nerve Glioma / Q000175:diagnosis* / Q000628:therapy; D019574:Optic Nerve Neoplasms / Q000175:diagnosis* / Q000628:therapy; D014792:Visual Acuity; D014795:Visual Pathways / Q000473:pathology*