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Optic nerve sheath meningiomas and advanced treatment options

Section Editor(s): Bilyk, Jurji EditorCarrasco, Jacqueline R; Penne, Robert B

Current Opinion in Ophthalmology: October 2004 - Volume 15 - Issue 5 - p 406-410
doi: 10.1097/
Oculoplastic and orbital surgery

Purpose of review Recent trends in the management of optic nerve sheath meningiomas have shifted towards fractionated conformal external beam radiotherapy. The purpose of this paper is to review the current literature on this subject and review the clinical characteristics and natural history of optic nerve sheath meningiomas.

Recent findings Articles published within the last 2 years have reported the efficacy of using fractionated radiation therapy alone. A total of 62 patients in three studies have been reported; 40.3% retained stable visual acuity, 41.2% percent had improvement in their vision, and 18.4% percent had a decrease in visual acuity. Median follow-up time ranged from 22 to 51 months in these studies.

Summary Optic nerve sheath meningiomas may be safely managed with fractionated external beam radiotherapy in select patients with possible improvement or stabilization of visual acuity. This represents an enormous improvement in a disease with typically poor visual prognosis.

Wills Eye Hospital, Oculoplastic and Orbital Surgery Service, Philadelphia, Pennsylvania, USA

Correspondence to Jacqueline R. Carrasco, MD, Wills Eye Hospital, 840 Walnut Street, Suite 910, Philadelphia, PA 19107, USA

Tel: 215 928 3250; fax: 215 928 3276; e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.