J Korean Ophthalmol Soc > Volume 52(1); 2011 > Article
Journal of the Korean Ophthalmological Society 2011;52(1):74-85.
DOI: https://doi.org/10.3341/jkos.2011.52.1.74    Published online January 15, 2011.
Clinical Features and Management Outcome of Optic Nerve Sheath Meningioma in Korea.
Eun Kyoung Lee, Seong Joon Kim, Sun Ha Paek, Dong Gyu Kim, Il Han Kim, Sang In Khwarg
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. ophjun@snu.ac.kr
2Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
3Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
4Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
한국에서의 시신경 수막종 환자의 임상 양상 및 치료 결과
이은경1,2ㆍ김성준1,2ㆍ백선하3ㆍ김동규3ㆍ김일한4ㆍ곽상인1,2
Department of Ophthalmology, Seoul National University College of Medicine1, Seoul, Korea Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute2, Seoul, Korea Department of Neurosurgery, Seoul National University College of Medicine3, Seoul, Korea Department of Radiation Oncology, Seoul National University College of Medicine4, Seoul, Korea
Abstract
PURPOSE
To evaluate the clinical features and treatment results of optic nerve sheath meningioma (ONSM) in Korean patients. METHODS: The present retrospective noncomparative case series was comprised of 10 eyes of 10 patients with a diagnosis of ONSM who were treated between 1997 and 2010 at the Seoul National University Hospital. RESULTS: The mean age at presentation was 47.9 years. Two males and 8 females participated in the study. Decreased vision and proptosis were the most common presenting symptoms. On imaging, the most common pattern was tubular. The most common histopathologic pattern was a meningothelial type. Two patients who were observed maintained good vision during the follow-up period and showed a slow progression of the tumor. Two patients out of 3 who underwent surgical management presented significant visual loss and complications. Three patients in the gamma-knife surgery (GKS) group showed no significant changes in visual acuity after treatment; however, tumor growth was halted. Two patients who underwent 3-dimensional conformal radiotherapy (3D-CRT) presented improvement in their visual acuity or visual field, and tumor growth was halted. CONCLUSIONS: Management should be conservative in most cases because of the slow and indolent growth pattern of ONSM. However, 3D-CRT can be considered as an initial treatment in patients with progressive visual deterioration and having still higher possibility of vision maintenance. GKS can be indicated in patients with progressive visual deterioration and a rare possibility of visual recovery. Surgical indications for ONSM are limited and must be carefully considered for each patient.
Key Words: Meningioma;Optic nerve sheath meningioma;Orbital meningioma


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