J Korean Ophthalmol Soc > Volume 57(9); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(9):1339-1347.
DOI: https://doi.org/10.3341/jkos.2016.57.9.1339    Published online September 15, 2016.
Clinical Course of Optic Nerve Sheath Meningioma.
Ji Min Lee, Si Yoon Park, Sang Yeul Lee, Jin Sook Yoon, Chang Yeom Kim
1The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. ecykim@yuhs.ac
2Lee's Eye Clinic, Seoul, Korea.
시신경 수막종의 치료 및 임상 경과
이지민1⋅박시윤1⋅이상열2⋅윤진숙1⋅김창염1
연세대학교 의과대학 안과학교실 시기능개발연구소1, 이상열 안과2
Correspondence:  Chang Yeom Kim,
Email: ecykim@yuhs.ac
Received: 4 May 2016   • Revised: 11 July 2016   • Accepted: 19 August 2016
Abstract
PURPOSE
To evaluate the clinical course of optic nerve sheath meningioma (ONSM) in Korean patients. METHODS: A retrospective study of 11 eyes of 11 patients with a diagnosis of ONSM between 2002 and 2015 at Severance Hospital. RESULTS: The mean age at symptom onset was 47.6 years. Ten females and 1 male participated in the study and all tumors were unilateral. Patients typically presented with visual loss and proptosis. Three patients complained of limited extraocular movements and seven patients exhibited visual field defects. Three patients who had a greater growth rate with intracranial involvement and two patients who had decreased vision received treatments. Five patients maintained good vision and visual field during the follow-up period. However, one patient who underwent surgical treatment presented significant visual loss and deterioration of visual field defect. One out of two patients who received three-dimensional conformal radiotherapy (3D-CRT) experienced improvement in visual field, and the other showed no change in visual field defect but remained stable with decreased tumor size. One out of two patients who underwent gamma-knife surgery showed aggravated visual field defect and the other presented with visual loss. CONCLUSIONS: ONSM is typically a slow-growing tumor. Deterioration of visual loss and visual field defect can occur after treatment of ONSM. Therefore, management should be considered carefully and should be limited to cases in which progression of the disease is advanced or tumor growth is fast. 3D-CRT can be considered in patients in need of treatment.
Key Words: Meningioma;Optic nerve sheath meningioma;Optic nerve tumor


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