Surgical management of an optic nerve glioma with perineural arachnoidal gliomatosis growth pattern

Aiyin Chen, Michael K. Yoon, Sarah Haugh, Laura T. Phan, Jonathan Song, Timothy J. McCulley

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

We describe a vision sparing surgical approach for optic nerve glioma. A 7-year-old girl experienced declining academic performance and social withdrawal attributed to progressive disfiguring proptosis. Three years earlier, she had undergone a limited biopsy, a course of chemotherapy, and orbital radiation therapy for a right optic nerve glioma with perineural arachnoidal gliomatosis (PAG). Because of marked proptosis, another surgery was performed via a lateral orbitotomy. After cutting a window in the thickened dura of the optic nerve, rouge colored spongy tissue was suctioned from the subarachnoid space. Small, more solidified areas were excised with unipolar cautery. Care was taken to avoid identifiable blood vessels and the optic nerve, and approximately 60%-70% of the tumor was removed. The dural window was approximated with interrupted sutures. Postoperatively, there was 9 mm reduction in right proptosis and visual acuity improved to from 20/70 to 20/60. This case illustrates the possibility of debulking optic nerve gliomas without sacrificing vision. It should be stressed that this technique is only applicable to gliomas with PAG and the durability of the surgical benefit is unknown.

Original languageEnglish (US)
Pages (from-to)51-53
Number of pages3
JournalJournal of Neuro-Ophthalmology
Volume33
Issue number1
DOIs
StatePublished - Mar 1 2013

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology

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