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Spontaneous Visual Improvement In Chiasmal Gliomas

Liu & Lessell, 1992Brain tumor

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

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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

16-year-old boy with 12 years of gradual bilateral loss in vision

Clinical Characteristics

16yo boy with 12 years of progressive loss of vision. Referred to neuro-ophthamology. No pmh of neurofibromatosis but had cafe au lait spots. Exam showed vision loss, color vision defect, field defects, exophthalmos. Bilateral optic n atrophy. Ct: suprasellar mass consistent with chiasmatic glioma, partial absence of left sphenoid bone. No treatment given.

Remission Characteristics

At 20 years of age, spontaneous improvement of visual acuity although color and visual fields remained unchanged. At 25years of age, follow up showed same changes and MRI was unchanged.

Treatment & Mechanisms

Proposed Remission Mechanisms

Possible tumor cell necrosis or immune mechanism

Clinical Treatment

None reported

Non-Clinical Treatment

None reported