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Tao B, Handzic A, Margolin E. Presumed Malignant Optic Glioma of Adulthood: Prolonged Survival with Temozolomide and Radiotherapy. Can J Neurol Sci 2023:1-3. [PMID: 37993120 DOI: 10.1017/cjn.2023.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Affiliation(s)
- Brendan Tao
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Armin Handzic
- Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Edward Margolin
- Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
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Cao Y, Tang X, Zan X, Li S. Benign optic nerve gliomas in an adult: A case report. Medicine (Baltimore) 2022; 101:e30132. [PMID: 36042601 PMCID: PMC9410573 DOI: 10.1097/md.0000000000030132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE Benign optic nerve gliomas were rarely found in adults, and total resection of these lesions seems impossible. We aimed to share a rare clinical case with an unusual and instructive treatment process. PATIENT CONCERNS A 52-year-old woman complained of a 4-month history of visual disturbance. Automated perimetry revealed visual field defect in her both eyes. DIAGNOSIS This patient was diagnosed with optic nerve glioma. We found its pathological features consistent with the pilocytic astrocytomas (WHO grade I). INTERVENTIONS A total resection of the tumor was smoothly performed. OUTCOMES Repeat MRI 3 months after the surgery demonstrated no recurrence of the lesion. Two years of postoperative telephone follow-up showed a stable status of improved vision. LESSONS We reported this interesting case to show a rare kind of condition regarding optic nerve gliomas in adults, which might help neurosurgeons like us to diagnose and treat these "invisible" tumors.
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Affiliation(s)
- Yarong Cao
- Department of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xinpu Tang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xin Zan
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shuangqing Li
- Department of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Shuangqing Li, Department of General Practice, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China (e-mail: )
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Zagirov RI, Trunin YY, Serova NK, Pronin IN, Antipina NA, Golanov AV. Hypofractionated stereotactic irradiation for optic nerve glioma. Zh Vopr Neirokhir Im N N Burdenko 2022; 86:74-80. [PMID: 36252196 DOI: 10.17116/neiro20228605174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
UNLABELLED Optic nerve glioma is a rather rare tumor. It predominantly arises in pediatric patients, including those with type I neurofibromatosis. This neoplasm is accompanied by decreased visual function and exophthalmos. Treatment strategy is individualized depending on age, volume and spread of tumor, as well as severity of clinical manifestations. Possible treatment options are surgical resection, chemotherapy, radiotherapy and their combination. Radiotherapy can be recommended for patients with intact visual functions, no severe proptosis and trophic lesions. Classic fractionation mode is used as a standard. Currently, the possibility of hypofractionated irradiation is being considered. OBJECTIVE To evaluate safety and efficacy of hypofractionated radiotherapy in patients with optic nerve glioma. MATERIAL AND METHODS Sixteen patients with optic nerve gliomas underwent hypofractionated stereotactic irradiation (CyberKnife) between May 2014 and October 2019. Single focal dose was 5.5 Gy. There were 5 fractions up to total focal dose of 27.5 Gy. The sample enrolled 14 children with a median age of 4 years (range 23 months - 13 years) and 2 adults aged 47 and 66 years, respectively. Median of tumor volume was 2.77 cm3 (range 1.69-10.01 cm3). RESULTS Tumor growth control was achieved in all patients, partial remission was observed in 5 (32%) patients. None patient had deterioration of visual function. Improvement of visual acuity was noted in 3 (19%) cases. Visual field enlargement occurred in 4 (67%) out of 6 patients who were preoperatively examined. After irradiation, proptosis decreased by ≥ 1 mm in 9 (60%) out of 15 patients.
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Affiliation(s)
- R I Zagirov
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - N K Serova
- Burdenko Neurosurgical Center, Moscow, Russia
| | - I N Pronin
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - A V Golanov
- Burdenko Neurosurgical Center, Moscow, Russia
- Moscow Gamma Knife Center, Moscow, Russia
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Hussain Z, Khan J, Saeed A, Dihowm F. Occurrence of Second Primary Malignancies in Patients With Primary Optic Nerve Gliomas: A Surveillance, Epidemiology, and End Results Analysis. Cancer Diagn Progn 2021; 1:393-398. [PMID: 35403153 PMCID: PMC8962871 DOI: 10.21873/cdp.10052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM Advanced understanding of screening and therapeutic modalities acts as provision for increased survival in patients diagnosed with optic nerve gliomas. Secondary primary malignancies (SPMs) in patients diagnosed with primary optic nerve glioma (OPG) are currently an uncharacterized frontier. This US national database analysis highlights the incidences of SPMs in patients diagnosed with primary OPG. MATERIALS AND METHODS Standardized incidence ratios (SIR) and excess absolute risk (EAR) for SPMs were calculated using the SEER-specific multiple outcome analysis. 95% SIR confidence intervals were calculated with statistical significance achieved at p<0.05. RESULTS SPMs originating from soft tissues (including the heart) (SIR=33.23, CI=6.85-97.11; EAR=5.07), breast (SIR=4.99, CI=1.36-12.77; EAR=5.57), female breast (SIR=5.03, CI=1.37-12.89; EAR=5.58), brain (SIR=105.38, CI=65.23-161.08; EAR=36.23), cranial nerves (SIR=103.29, CI=12.51-373.12; EAR=3.45), non-lymphocytic leukemia (SIR=15.05, CI=1.82-54.37; EAR=3.25), myeloid and monocytic leukemia (SIR=16.26, CI=1.97-58.75; EAR=3.27), and Kaposi's sarcoma (SIR=79.88, CI=2.02-445.08; EAR=1.72) demonstrated significantly increased SIR. Overall, the values for cumulative SPM (SIR=6.04, CI=4.33-8.19; EAR=59.60) highlight the overall significance in incidence of SPM in patients diagnosed with OPG. CONCLUSION Clinical decision-making should reconcile enhanced propensities for development of SPM.
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Affiliation(s)
- Zain Hussain
- University of Medicine and Health Sciences, Portland, ME, U.S.A
| | - Jawad Khan
- Texas Tech University Health Sciences Center - Paul L. Foster School of Medicine, El Paso, TX, U.S.A
| | - Amir Saeed
- Texas Tech University Health Sciences Center - Paul L. Foster School of Medicine, El Paso, TX, U.S.A
| | - Fatma Dihowm
- Texas Tech University Health Sciences Center - Paul L. Foster School of Medicine, El Paso, TX, U.S.A
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Abstract
Objectives To describe the diagnostic and management features of optic nerve gliomas. Design Literature review. Results Optic nerve gliomas are generally benign in the pediatric age group although they are usually malignant and aggressive in adults. As such, the mechanisms by which these lesions are diagnosed, the systemic implications, the goals of intervention, and the nature of therapeutic management all differ between these tumors. Conclusions This article addresses these lesions and discusses the diagnostic and therapeutic paradigms by which they may be approached.
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Affiliation(s)
- Edward J Wladis
- Department of Ophthalmology, Lions Eye Institute, Albany Medical College, Slingerlands, New York, United States
| | - Matthew A Adamo
- Department of Neurosurgery, Albany Medical College, Slingerlands, New York, United States
| | - Lauren Weintraub
- Division of Hematology/Oncology, Department of Pediatrics, Albany Medical College, Slingerlands, New York, United States
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Abstract
Purpose: The majority of pediatric patients with optic nerve gliomas (ONG) remain asymptomatic; however, a subset of patients suffer rapid, irreversible visual loss. The purpose of this study was to determine anatomic differences of ONG noted either by imaging or by intra-operative observation between patients with gradual visual dysfunction and those with rapid visual loss. Methods: A retrospective review was performed in patients with visual loss secondary to ONG. The clinical records, pathology, and radiographic images were reviewed for all patients. The degree of folding or plication of the optic nerve (ON) was determined by analyzing the most acute angle present in the course of the ON. Outcome measures: The primary outcome measure was the angle of plication or folding of the ON and the relationship of this to the course of visual dysfunction. Results: Six patients with ONG were included in the study. A structural difference in the ON was identified in four patients with rapid vision loss compared with two patients with more gradual visual dysfunction. In patients with rapid progressive visual loss, the ONG had a 90-degree or more acute plication of the ON. Those with more gradual visual loss had more obtuse bends in the ONG. Conclusions: We have identified that the intrinsic structure of the ONG may contribute to the rare but devastatingly rapid progression of visual dysfunction in some patients. Recognizing these changes may guide clinicians to intervene prior to the development of irreversible visual loss.
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Affiliation(s)
- Andrea A Tooley
- Department of Ophthalmology, Harkness Eye Institute, Columbia University , New York, New York, USA.,Department of Ophthalmology, Mayo Clinic , Rochester, Minnesota, USA
| | - Nailyn Rasool
- Department of Ophthalmology, Harkness Eye Institute, Columbia University , New York, New York, USA
| | - Ashley Campbell
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins , Baltimore, Maryland, USA
| | - Michael Kazim
- Department of Ophthalmology, Harkness Eye Institute, Columbia University , New York, New York, USA
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Kokkinou E, Roka K, Alexopoulos A, Tsina E, Nikas I, Krallis P, Thanopoulou I, Nasi L, Makrygianni E, Tsoutsou E, Kosma K, Tsipi M, Tzetis M, Frysira H, Kattamis A, Pons R. Development of a multidisciplinary clinic of neurofibromatosis type 1 and other neurocutaneous disorders in Greece. A 3-year experience. Postgrad Med 2019; 131:445-452. [PMID: 31443616 DOI: 10.1080/00325481.2019.1659708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Given the complexity of neurocutaneous syndromes, a multidisciplinary approach has been advocated in order to provide optimum care. Subjects and Methods: Retrospective analysis of a cohort of 157 patients during a 3-year period, seen at a newly developed neurocutaneous clinic in a pediatric tertiary care hospital in Athens (Greece); and systematic chart review of the patients diagnosed with neurofibromatosis type 1 during this time period. Results: The most frequent neurocutaneous syndromes were neurofibromatosis type 1 (NF1) in 89 patients and tuberous sclerosis complex in 17. In 20.38% of patients a neurocutaneous syndrome was not confirmed. Approximately 2/3 of the NF1 patients underwent genetic analysis, and for 76.67% of them, a pathogenic mutation on the NF1 gene was revealed. Eighty-one patients manifested with generalized NF1 and eight with mosaic NF1. Dermatological manifestations included café-au-lait macules in all patients, followed by axillary and/or inguinal freckling (n = 57), external plexiform neurofibromas (n = 17), and cutaneous and subcutaneous neurofibromas (n = 11). Approximately half of patients had learning disabilities and attention deficit hyperactivity disorder, followed by mental retardation (n = 9), autistic spectrum disorders (n = 4), headaches (n = 3) and seizures (n = 2). Neuroimaging showed characteristic areas of hyperintensity on T2-weighted images in 74.07% of patients and optic pathway glioma in 19.75%. Two patients developed malignant peripheral sheath nerve tumor. Conclusions: Neurocutaneous syndromes are clinically heterogeneous and the surveillance of potential clinical complications is challenging. The availability of genetic diagnosis and novel imaging methods in this group of disorders is likely to further expand their clinical spectrum. Guidelines for assessment and management will need to be modified based on new available data.
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Affiliation(s)
- Eleftheria Kokkinou
- Special Unit of Pediatric Neurology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Kleoniki Roka
- Division of Pediatric Hematology-Oncology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Alexis Alexopoulos
- Special Unit of Dermatology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Efthymia Tsina
- Department of Ophthalmology, Agia Sofia Children's Hospital , Athens , Greece
| | - Ioannis Nikas
- Department of Radiology, Agia Sofia Children's Hospital , Athens , Greece
| | - Panagiotis Krallis
- Department of Orthopaedics, Agia Sofia Children's Hospital , Athens , Greece
| | - Ioanna Thanopoulou
- Special Unit of Dermatology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Lambrini Nasi
- Special Unit of Dermatology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Evanthia Makrygianni
- Special Unit of Pediatric Neurology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Eirini Tsoutsou
- Department of Medical Genetics, Choremio Research Laboratory, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Konstantina Kosma
- Department of Medical Genetics, Choremio Research Laboratory, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Maria Tsipi
- Department of Medical Genetics, Choremio Research Laboratory, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Maria Tzetis
- Department of Medical Genetics, Choremio Research Laboratory, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Helen Frysira
- Department of Medical Genetics, Choremio Research Laboratory, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Antonis Kattamis
- Division of Pediatric Hematology-Oncology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
| | - Roser Pons
- Special Unit of Pediatric Neurology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Agia Sofia Children's Hospital , Athens , Greece
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Robert-Boire V, Rosca L, Samson Y, Ospina LH, Perreault S. Clinical Presentation and Outcome of Patients With Optic Pathway Glioma. Pediatr Neurol 2017; 75:55-60. [PMID: 28847625 DOI: 10.1016/j.pediatrneurol.2017.06.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Optic pathway gliomas (OPGs) occur sporadically or in patients with neurofibromatosis type 1 (NF1). The purpose of this study was to evaluate the clinical presentation at diagnosis and at progression of patients with OPGs. METHODS We conducted a chart review of patients with OPGs diagnosed in a single center over a period of 15 years. Demographic data including age, sex, NF1 status, clinical presentation, and outcome were collected. RESULTS Of the 40 patients who were identified, 23 had sporadic tumors (57.5%) and 17 had NF1-related tumors (42.5%). Among the children with NF1, there was a significant overrepresentation of girls (82.3%) (P = 0.02), while among the children without NF1, there were slightly more boys (56.5%) than girls (43.5%). The presence of nystagmus was strongly associated with sporadic optic pathway gliomas. Poor visual outcome was related to tumor affecting both optic pathways, hydrocephalus at diagnosis, and optic nerve atrophy. Of the 40 patients, five died of OPG complications (12.5%) and all had sporadic tumors. CONCLUSIONS Our cohort is one of the largest with OPGs and a detailed description of the clinical presentation both at diagnosis and at progression. We observed a significant difference between sporadic and NF1 optic pathway gliomas in terms of demographics, clinical presentation, and outcome.
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Affiliation(s)
- Viviane Robert-Boire
- Department of Pediatrics, Division of Child Neurology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Lorena Rosca
- Department of Pediatrics, Division of Child Neurology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Yvan Samson
- Department of Pediatrics, Division of Hemato-Oncology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Luis H Ospina
- Department of Ophthalmology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Sébastien Perreault
- Department of Pediatrics, Division of Child Neurology, CHU Sainte-Justine, Montreal, Quebec, Canada.
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Abstract
Diseases of the orbit can be categorized in many ways, but in this chapter we shall group them according to etiology. Inflammatory diseases of the orbits may be infectious or noninfectious. Of the infections, orbital cellulitis is the most common and typically arises as a complication of acute sinusitis. Of the noninfectious, inflammatory conditions, thyroid orbitopathy is the most common and results in enlargement of the extraocular muscles and proliferation of the orbital fat. Idiopathic orbital inflammatory syndrome is another cause of inflammation in the orbit, which may mimic thyroid orbitopathy or even neoplasm, but typically presents with pain. Masses in the orbit may be benign or malignant and the differential diagnosis primarily depends on the location of the mass lesion, and on the age of the patient. Lacrimal gland tumors may be lymphomas or epithelial lesions of salivary origin. Extraocular muscle tumors may represent lymphoma or metastases. Tumors of the intraconal fat are often benign, typically hemangiomas or schwannomas. Finally, globe tumors may be retinoblastomas (in children), or choroidal melanomas or metastases in adults.
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Affiliation(s)
- Mary Beth Cunnane
- Department of Radiology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA, USA; Division of Neuroradiology, Massachusetts General Hospital, Boston, MA, USA.
| | - Hugh David Curtin
- Department of Radiology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA, USA
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Abstract
Pediatric genetic ocular tumors include malignancies like retinoblastoma and phakomatosis like neurofibromatosis, tuberous sclerosis, von Hippel-Lindau syndrome, and nevoid basal cell carcinoma syndrome. It is important to screen for ocular tumors both for visual prognosis and also for systemic implications. The phakomatosis comprise of multitude of benign tumors that are aysmptomatic but their detection can aid in the diagnosis of the syndrome. Retinoblastoma is the most common malignant intraocular tumor in childhood and with current treatment modalities, the survival is more than 95%. It is transmitted as an autosomal dominant fashion and hence the offsprings of all patients with the germline retinoblastoma need to be screened from birth. This review discusses the various pediatric genetic ocular tumors discussing the clinical manifestation, diagnosis and treatment.
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Affiliation(s)
- Behnaz Rouhani
- Department of Ophthalmology, Drexel University, Philadelphia, PA, USA
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Hrisomalos FN, Maturi RK, Pata V. Long-term use of intravitreal bevacizumab (avastin) for the treatment of von hippel-lindau associated retinal hemangioblastomas. Open Ophthalmol J 2010; 4:66-9. [PMID: 21293730 PMCID: PMC3032222 DOI: 10.2174/1874364101004010066] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 08/10/2010] [Accepted: 08/25/2010] [Indexed: 11/22/2022] Open
Abstract
Retinal hemangioblastomas are the most common manifestation of Von Hippel-Lindau (VHL) disease [1-3].
While peripheral retinal hemangioblastomas may be treated by thermal laser treatment or cryotherapy, optic nerve and
macular lesions are more difficult to treat [4, 5]. Based on the theoretical benefit of administering anti-VEGF treatment,
intra-vitreally administered bevacizumab (Avastin, a general pan-VEGF inhibitor) is attractive [6, 7].
Several short-term case series using ranibizumab (Lucentis, mAb fragment of bevacizumab with stronger affinity for
VEGF-A) have shown it has promising but minimal success on most VHL-related hemangioblastomas [8, 9]. A
comprehensive study by Wong et al. examined 5 patients over a period up to 61 weeks (47 ± 14 weeks) while Michels et al. examined one patient over a period of 4 months. Due to the short-term nature of these studies, we attempted long-term
bevacizumab treatment over 60 months in a monocular subject with progressive visual loss due to a VHL associated
macular and optic nerve hemangioblastoma. Over the treatment regimen of 15 injections, visual acuity improved 25
letters, OCT thickness improved from 646 um to 424 um, and structural lesions stabilized while exudates and edema
resolved.
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Affiliation(s)
- Frank N Hrisomalos
- Indiana University Department of Ophthalmology, Indianapolis, Indiana, USA
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Chan CC, Koch CA, Kaiser-Kupfer MI, Parry DM, Gutmann DH, Zhuang Z, Vortmeyer AO. Loss of heterozygosity for the NF2 gene in retinal and optic nerve lesions of patients with neurofibromatosis 2. J Pathol 2002; 198:14-20. [PMID: 12210058 PMCID: PMC2543125 DOI: 10.1002/path.1174] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Individuals affected with the neurofibromatosis 2 (NF2) cancer predisposition syndrome develop specific ocular lesions. To determine whether these lesions result from altered NF2 gene expression, microdissection and PCR were used to investigate 40 ocular lesions from seven eyes of four NF2 patients for LOH, with markers that flank the NF2 gene on chromosome 22q. NF2 protein (merlin) expression was also evaluated in these lesions, using immunohistochemistry. Retinal hamartoma was observed in all seven eyes, including one with combined pigment epithelial and retinal hamartoma (CPERH). Retinal tufts were present in four eyes (three patients), retinal dysplasia in two eyes (two patients), optic nerve neurofibroma in one eye, iris naevoid hyperplasia in two eyes (two patients) and pseudophakia in all eyes. Markers were informative in three patients (six eyes from three unrelated families). One patient was non-informative due to prolonged decalcification. All retinal and optic nerve, but not iris lesions, demonstrated consistent LOH for the NF2 gene. Merlin was not expressed in the retina, optic nerve, or iris lesions. These results suggest that inactivation of the NF2 gene is associated with the formation of a variety of retinal and optic nerve lesions in NF2 patients.
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Affiliation(s)
- Chi-Chao Chan
- National Eye Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
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