Optic pathway tumors

Optic pathway tumors refer to glial tumors that involve the anterior visual axis, i.e., the optic nerve chiasm and tract. Because of their indolent nature, there has been little consensus regarding when or how to treat these tumors. From 15% to 35% of optic pathway tumors have been associated with neurofibromatosis. Upon evidence of progression of an intraorbital mass, surgery, although sacrificing vision, may provide a complete cure. For tumors that present intracranially, treatment consists of biopsy when appropriate, followed by adjuvant therapy, i.e., radiation or chemotherapy. This article reviews the above issues and the anatomy, presentation, and natural history of tumors of this anatomic region.