Treatment of optic nerve sheath meningioma with three-dimensional conformal radiation

doi:10.1016/S0002-9394(99)00477-8

American Journal of Ophthalmology

Volume 129, Issue 5, May 2000, Pages 694-696

https://doi.org/10.1016/S0002-9394(99)00477-8 Get rights and content

Abstract

PURPOSE: To report a patient recovering vision after three-dimensional conformal radiotherapy for optic nerve sheath meningioma.

METHODS: Radiotherapy was delivered by a three-dimensional conformal technique in 28–180-cGy fractions.

RESULTS: Visual acuity improved from 20/200 to 20/30, and the visual field defect resolved.

CONCLUSION: Visual loss from optic nerve sheath meningioma can be reversed by three-dimensional conformal radiotherapy.

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There are more references available in the full text version of this article.

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Optimal management in optic nerve sheath meningioma – A multicentre study and pooled data analysis
2020, Journal of Clinical Neuroscience
Citation Excerpt :
This is in keeping with the results of Turbin et.al. [8] and other studies [6,7,11–41], supporting radiotherapy as an effective treatment option. Subgroup analysis found subjective visual decline was associated with an improved VA of >2 Snellen lines post-treatment (p = 0.044).
Optic nerve sheath meningiomas (ONSMs) are rare, benign neoplasms of the anterior visual pathway. The optimal modality of radiotherapy for treatment has not yet been established. This is the first study to show significant difference in visual outcomes between radiotherapy subtypes in the management of ONSM. We performed a retrospective analysis of visual outcomes and side effects in ONSM patients treated with radiotherapy at three centres in Sydney, Australia, between 2000 and 2016. 15 patients with ONSM were included, and visual outcomes (visual acuity, visual fields, colour vision, OCT retinal nerve fibre layer thickness and radiological tumour response) and treatment toxicities were assessed. Pooled data analysis of available studies was also performed. Statistical analysis was performed with binomial, two-tailed chi-squared tests and Fisher exact tests. In our cohort a significant majority experienced improved visual field (p = 0.046), stable or improved visual acuity (p = 0.0017) and colour vision (p = 0.015) after fractionated radiotherapy. Pooled analysis with strict inclusion criteria found 3D conformal radiotherapy to offer significantly poorer visual acuity compared to fractionated stereotactic radiotherapy (p = 0.008). When all published studies were included, stereotactic radiosurgery was superior to 3D conformal methods (p = 0.035), and equivalent to other fractionated methods. 3D conformal methods also had significantly higher rates of long-term side effects. These results support the use of fractionated radiotherapy and radiosurgery for ONSM treatment, however 3D conformal methods cannot be recommended.
Long-term treatment outcomes of patients with primary optic nerve sheath meningioma treated with stereotactic radiotherapy
2019, Journal of Clinical Neuroscience
We analysed the long-term outcomes of patients with primary optic nerve sheath meningioma (ONSM) treated with stereotactic radiotherapy (SRT). 26 patients with primary ONSM were treated with SRT between 2004 and 2013 at a single institution. SRT was delivered with image guidance to a median dose of 50.4 Gy in 28 fractions. 4 patients had prior surgical debulking. At a median radiological follow-up of 68 months, the MRI based tumour control was 100%. Visual acuity improved in 10 (38.4%), remained stable in 10 (38.4%) and was reduced in 6 (23.1%) patients following treatment. Stable or improved vision post-treatment was seen in 92.3% of patients with good pre-treatment vision (best corrected visual acuity 6/18 or better), compared to only 61.5% of patients with poor pre-treatment vision (best corrected visual acuity 6/24 or worse). Overall, the treatment was well tolerated with no Grade 2 or greater acute toxicity. Minimal other ophthalmic complications were seen with only one patient developing late onset Grade 3 radiation retinopathy.
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Brief reportsTreatment of optic nerve sheath meningioma with three-dimensional conformal radiation

Abstract

Am J Ophthalmol

Neurol Clin

Brief reports
Treatment of optic nerve sheath meningioma with three-dimensional conformal radiation