Spontaneous Visual Improvement In Chiasmal Gliomas
Liu, G. T., & Lessell, S. (1992). spontaneous visual improvement in chiasmal gliomas. American journal of ophthalmology, 114(2), 193–201. https://doi.org/10.1016/s0002-9394(14)73984-4
View Original Source →Abstract
Three untreated patients with presumed chiasmal gliomas had spontaneous visual improvement, although serial magnetic resonance imaging in two of the patients showed the lesions to be unchanged. Two patients had evidence of neurofibromatosis. Three other patients with similar disease courses have been documented in the medical literature. These cases demonstrate that conservative management of optic chiasmal gliomas may sometimes be associated with favorable outcomes.
Case Details
Disease Location
Right optic nerve glioma
Personal Characteristics
1. 9-year-old girl
Clinical Characteristics
9yo girl with right supraorbital pain, ophthalmic exam showed edematous optic disk. Visual acuity r 16/13, l 16/10, color vision normal, 1.5m exophthalmos. CT showed intrinsic right optic n lesion. Managed on observation. At 10 years of age, worsening visual acuity, exophthalmos, now loss of color vision and field of vision. CT showed involvement of the chiasm. 3 months later: declining visual acuity, total loss of color vision and peripheral vision in right eye. Ct: intra-orbital enlargement of the tumor, widening of the right optic canal, involvement of both sides of the chiasm. 6 months later: vision worse, pale optic disk, central scotoma in right visual field. 14years of age: MRI suggestive of glioma. Examination up to 32 months later showed same findings incl imaging findings.
Remission Characteristics
At 17.5 years of age, examination showed tremendous spontaneous improvement in visual acuity, central scotoma, MRI unchanged.
Treatment & Mechanisms
Proposed Remission Mechanisms
Possible tumor cell necrosis or immune mechanism
Clinical Treatment
None reported
Non-Clinical Treatment
None reported