Management can involve:
Observation alone:
Not all patients with identifiable optic pathway gliomas on imaging ever have visual symptoms (especially if the patient has NF-1).
Spontaneous regression of these tumors has been documented (in patients with and without NF1)2.
In many patients with mild symptoms, observation is recommended because
- Symptoms are mild and there is no immediate threat to vision.
- The natural history of disease is most likely very slow (NF1)
- The patient is young and the aim is to reduce the risk of treatment related morbidity.
In a study looking at the natural history of these tumors, progression of disease was seen on observation in:
- 70% of patients without NF1
- 13% of patients with NF1
Flicker visual evoked potentials (F-VEPs) and MRI imaging of the brain can be used to follow patients with optic pathway glioma closely and detect recurrence early3.
