Article for CME CreditA long-term visual outcome comparison in patients with optic nerve sheath meningioma managed with observation, surgery, radiotherapy, or surgery and radiotherapya ☆,
Section snippets
Patients and methods
All patients with a clinical history and course suggestive of optic nerve sheath tumor who had radiographic characteristics consistent with ONSM from a referral based University practice (Allegheny General Hospital, Eye and Ear Hospital of Pittsburgh, Dean A. McGee Eye Institute of University of Oklahoma, and New York University) were identified by retrospective chart reviews.13, 14, 15, 16, 17, 18 (Table 1). A subset of these patients was previously reported.12, 19 In addition, cases were
Results
Sixty-four patients were identified with a mean follow-up period of 150.2 months (range, 51–516 months; SD, 74.7). There were 55 women (85.9%) and nine men (14.1%). For the 59 patients used in statistical analysis, the mean follow-up was 138.5 months (range, 57–277 months; SD, 55.4). The diagnosis was confirmed by histopathologic examination in 32 cases. Five of the 64 patients were excluded from statistical analysis because of the NLP vision criterion. Mean age in all patients at diagnosis was
Discussion
In this case series, radiation alone was the only mode of management that did not result in an overall significant decrease in visual acuity when the various visual acuity parameters were subject to outcome analysis at the last follow-up. As noted in Table 7, many patients treated with radiation realized improved function, although this was not significant when visual acuity measures at diagnosis were compared with visual acuity measures at the last follow-up. The power of the treatment effect
Acknowledgements
The authors thank James D. Schlosser, MS and Joyce A. D’Antonio, PhD (Center for Clinical Effectiveness & Outcomes Research, Allegheny General Hospital, Pittsburgh, PA) for statistical analysis. The authors also thank Bradley K. Farris, MD, William R. Rothfus, MD, Floyd A. Warren, MD, Dai Barr, MB, DO, William T. Shults, MD, Mark L. Moster, MD, Richard H. Legge, MD, James Bolling, MD, Robert S. Hepler, MD, William S. Fagman, MD, Mark H. Levy, MD, Myles Behrens, MD, Leon F. Cashwell, MD, Robert
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Supported, in part, by an Unrestricted Grant from Research to Prevent Blindness, Inc., New York, New York; Fund for the New Jersey Blind, Newark, New Jersey; Lions Eye Research Foundation of New Jersey,Newark, New Jersey; and the Eye Institute of New Jersey, Newark, New Jersey.
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No author has any commercial interest in any of the opinions expressed in this article.