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Clinical science
Primary radiotherapy in progressive optic nerve sheath meningiomas: a long-term follow-up study
  1. Peerooz Saeed1,
  2. Leo Blank2,
  3. Dinesh Selva3,
  4. John G Wolbers4,
  5. Peter J C M Nowak4,
  6. Ronald B Geskus5,
  7. Ezekiel Weis1,6,
  8. Maarten P Mourits1,7,
  9. Jack Rootman8,9
  1. 1Orbital Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
  2. 2Department of Radiotherapy, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
  3. 3Discipline of Ophthalmologyv Visual Sciences, University of Adelaide and South Australian Institute of Ophthalmology, Australia
  4. 4Departments of Neurosurgery and Radiotherapy, Erasmus University Medical Center Rotterdam, the Netherlands
  5. 5Department of Epidemiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
  6. 6Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada
  7. 7Department of Ophthalmology, University Hospital Utrecht, the Netherlands
  8. 8Department of Pathology, University of British Columbia and the Vancouver General Hospital, Vancouver, British Columbia, Canada
  9. 9Department of Ophthalmology and Visual Sciences, University of British Columbia and the Vancouver General Hospital, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Peerooz Saeed, Orbital Center/Department of Ophthalmology, University of Amsterdam, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, the Netherlands; p.saeed{at}amc.uva.nl

Abstract

Background/aims To report the outcome of primary radiotherapy in patients with progressive optic nerve sheath meningioma (ONSM).

Methods The clinical records of all patients were reviewed in a retrospective, observational, multicentre study.

Results Thirty-four consecutive patients were included. Twenty-six women and eight men received conventional or stereotactic fractionated radiotherapy, and were followed for a median 58 (range 51–156) months. Fourteen eyes (41%) showed improved visual acuity of at least two lines on the Snellen chart. In 17 (50%) eyes, the vision stabilised, while deterioration was noted in three eyes (9%). The visual outcome was not associated with age at the time of radiotherapy (p=0.83), sex (p=0.43), visual acuity at the time of presentation (p=0.22) or type of radiotherapy (p=0.35). Optic disc swelling was associated with improved visual acuity (p<0.01) and 4/11 patients with optic atrophy also showed improvement. Long-term complications were dry eyes in five patients, cataracts in three, and mild radiation retinopathy in four.

Conclusion Primary radiotherapy for patients with ONSM is associated with long-term improvement of visual acuity and few adverse effects.

https://doi.org/10.1136/bjo.2009.166793

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, see: http://www.textcheck.com/certificate/DzovnE