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Visual outcomes of fractionated radiotherapy in optic nerve sheath meningioma
Author(s) -
Kheir V.,
Borruat F.X.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0595
Subject(s) - medicine , visual acuity , interquartile range , ophthalmology , diplopia , optic nerve , radiation therapy , surgery
Purpose Optic nerve sheath meningioma (ONSM) is a rare benign tumor of the optic nerve sheath that can lead to blindness if untreated. We conducted a retrospective monocentric study to assess the effect of radiotherapy on tumor control and visual outcomes in patients with ONSM. Methods All patients diagnosed with ONSM at our centre were reviewed and data on: symptoms at presentation; visual acuity (VA), color vision and visual fields (VF); treatment type; visual outcome if treated with radiotherapy were recorded. Results There were 34 (26 female) patients reviewed. Presenting symptoms were decreasing vision (25 patients), subjective scotoma (4 patients), transient visual obscuration (4 patients), disturbance of color vision (1 patient), diplopia (4 patients), exophthalmia (3 patients), palpebral edema (2 patients), tearing (2 patients), conjunctival hyperaemia (2 patients), pain (8 patients) and headaches (3 patients). Median initial VA was 0.1 (interquartile range (IQR) 0–1) logMAR, color vision was 1 (13 plates) and VF mean defect was 7 dB. 16 patients were treated with fractionated radiotherapy (total 50.4 Gy/28 sessions) between 2002 and 2015. After radiotherapy, VA improved in 13 eyes, was unchanged in 1 eye and decreased in 2 eyes. Median best‐corrected VA improved from 0.1(IQR) (0–0.4) logMAR to 0 (−0.1 to 0) logMAR, color vision improved from 5 (0 to 12) to 12 (1 to 13), and median VF mean defect improved from 10 (5 to 19) dB to 4 (1 to 10) dB. Tumor size was reduced in 3 patients, and stable in 11 patients (not available in 2 patients). No adverse side‐effects were reported during the time of follow‐up. Conclusions Fractionated radiotherapy is a safe procedure and can be used to treat patients with ONSM. In our study, visual improvement was observed in 13 (81%) eyes and visual loss in 2 (12.5%) eyes.