Visual loss in children with neurofibromatosis type 1 and optic pathway gliomas: Relation to tumor location by magnetic resonance imaging
Visual loss in children with neurofibromatosis type 1 and optic pathway gliomas: Relation to tumor location by magnetic resonance imaging
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DOI：
10.1016/s0002-9394(00)00852-7
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发表时间：
2001-04-01
影响因子：
4.2
通讯作者：
Maguire, MG
中科院分区：
文献类型：
--
作者：
Balcer, LJ;Liu, GT;Maguire, MG
目的：通过磁共振成像研究一组患有 I 型神经纤维瘤病的儿童，检查视力丧失的可能性及其与视神经纤维瘤病范围和位置的关系。方法：我们回顾了费城儿童医院随访的 43 名连续 I 型神经纤维瘤病和视神经胶质瘤儿童患者的神经眼科记录和脑/眼眶磁共振成像扫描。确定视力丧失的存在，定义为一只或两只眼睛的年龄视力异常。通过磁共振成像，根据视神经、视交叉和视交叉后结构的受累情况，根据肿瘤范围和位置对视路神经胶质瘤进行分类。结果：肿瘤诊断时视神经束和其他视交叉后结构的受累与视力丧失的概率显着较高相关（P = 0.048，卡方检验）。 43 名患者中有 20 名 (47%) 出现视力丧失，中位年龄为 4 岁；然而，三名患者在青春期首次出现视力丧失。 结论：在患有 1 型神经纤维瘤病和视神经胶质瘤的儿科患者中，视力丧失的可能性取决于磁共振成像显示的肿瘤的范围和位置，尤其与视交叉后结构的受累有关。此外，童年（青春期）年龄较大并不排除视力丧失的发生。建议在儿童早期之后进行密切随访，特别是对于那些患有交叉后肿瘤的患者。 （美国眼科杂志 2001 年；131：442-445。(C) 2001 年，爱思唯尔科学公司。保留所有权利）。
PURPOSE: To examine the potential for visual acuity loss, and its relation to extent and location of optic pathway gliomas in a cohort of children with neurofibromatosis type I studied with magnetic resonance imaging.METHODS: We reviewed the neuro-ophthalmologic records and brain/orbital magnetic resonance imaging scans for 43 consecutive pediatric patients with neurofibromatosis type I and optic pathway gliomas who were followed at the Children's Hospital of Philadelphia. The presence of visual loss, defined as abnormal visual acuity for age in one or both eyes, was determined. Optic pathway gliomas were classified by tumor extent and location according to involvement of the optic nerves, chiasm, and postchiasmal structures by magnetic resonance imaging.RESULTS: involvement of the optic tracts and other postchiasmal structures at tumor diagnosis was associated with a significantly higher probability of visual acuity loss (P = .048, chi-square test). Visual loss was noted in 20 of 43 patients (47%) at a median age of 4 years; however, three patients developed visual acuity loss for the first time during adolescence.CONCLUSIONS: In pediatric patients with neurofibromatosis type 1 and optic pathway gliomas, the likelihood of visual loss is dependent on the extent and location of the tumor by magnetic resonance imaging and is particularly associated with involvement of postchiasmal structures. Furthermore, older age during childhood (adolescence) does not preclude the occurrence of visual loss. Close follow-up beyond the early childhood years, particularly for those with postchiasmal tumor, is recommended. (Am J Ophthalmol 2001;131:442-445. (C) 2001 by Elsevier Science inc. All rights reserved).