Optic nerve glioma

  • Young patients, peak in first decade
  • Bilateral lesions diagnostic of neurofibromatosis type 1
  • Pilocystic astrocytoma (WHO grade 1) most common. Little or no progression over time 
  • Visual loss less common in NF-1 
Imaging 
  • Fusiform enlargement of optic nerve
  • Expansion of optic canal
  • MRI most accurate, iso to hypo on T1, hyper  on T2 with variable enhancement 
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Chung, Ellen M., Charles S. Specht, and Jason W. Schroeder. “Pediatric orbit tumors and tumorlike lesions: neuroepithelial lesions of the ocular globe and optic nerve.” Radiographics 27.4 (2007): 1159-1186.