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Optic Glioma

Optic gliomas are uncommon neoplasms of astrocytic glial cells along the visual pathways. Optic nerve gliomas are seen most commonly in children at a mean age of 9 years old. In 76% of cases the optic chiasm is involved. Nearly 30% of cases are associated with neurofibromatosis type 1. Children present with slowly progressive protosis, motility restriction, and loss of vision. Lesions confined to the orbital optic nerve can be followed with serial MRI imaging.  For large lesions with marked proptosis and loss of vision, or those extending posteriorly threatening the chiasm, optic nerve excision or radiotherapy is usually recommended.  For chiasmal and CNS lesions, chemotherapy is indicated or radiotherapy for older children. 

Child with optic nerve glioma in the left orbit with proptosis
CT showing a fusiform optic nerve glioma
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