Year : 1974 | Volume
: 22 | Issue : 4 | Page : 22--23
Glioma of the optic nerve
GN Seal, A Dasgupta
Institute of Post-graduate Medical Education & Research, Calcutta, India
G N Seal
Deptt. of Ophthalmology, Institute of Post-graduate Medical Education & Research, Calcutta
|How to cite this article:|
Seal G N, Dasgupta A. Glioma of the optic nerve.Indian J Ophthalmol 1974;22:22-23
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Seal G N, Dasgupta A. Glioma of the optic nerve. Indian J Ophthalmol [serial online] 1974 [cited 2020 Sep 20 ];22:22-23
Available from: http://www.ijo.in/text.asp?1974/22/4/22/31347
Glioma of the optic nerve is relatively rare. Although the tumour is usually unilateral, simultaneous occurrence in both optic nerves has been reported.
A case of optic nerve glioma in a young man aged 18 is being presented.
J. M., a Hindu male aged 18 years was first examined in the Deptt. of Ophthalmology, S. S. K. M. Hospital in the first week of May, 1972 with complaint of gradual painless protrusion of his left eye for last one and half years. He also had gradual diminution of vision in the left eye for same duration. He stated that about one-and-half years back, he had a fall while playing and about a month following the injury, his left eye started bulging forward. His sight in the left eye also started falling and within a month, he became completely blind in that eye.
His personal and family histories did not reveal any thing contributary to the affection.
On general examination, the patient was of average built and well nourished, with no systemic abnormality relevent to the ocular condition.
On local examination, the right eye was found to be normal. Left eye showed marked degree of axial proptosis with almost full ocular motility in all directions of gaze [Figure 1]. Thepupil was dilated and immobile to light. Intra-ocular tension was within normal limits.
Perception of light was absent. On palpation, no mass could be felt in the orbit. Fundus examination revealed complete optic atrophy with neovascularization on the disc. Retinal vessels showed sheathing with narrowing of their lumen.
Investigations : All investigations including X-rays of orbits and skull were normal except left optic canal, which showed moderate enlargement.
Treatment : Kronlein's oribtotomy was done on the left side under general anaesthesia. A fusiform well-encapsulated mass was found behind the eyeball within the muscle cone. It was attached to the posterior aspect of the globe. The mass was removed by cutting the anterior attachment to the globe and the posterior constricted portion of the mass at the orbital apex. It measured about 20x3Omm. and the cut surface presented a smooth pinkish appearance. [Figure 2]
Progress : Immediate post-operative recovery was uneventful. The patient was discharged from the hospital after two weeks with the advice for periodic check up. Proptosis disappeared completely within a month from the date of operation. The affected eye now appeared normal with fair degree of ocular movements except abduction which was markedly restricted.
Histopathology : The mass was well-capsulated and fusiform in shape. The surface was smooth and consistency was firm. The cut surface appeared granular and pinkish in colour. Microscopic examination presented a reticulated appearance with bundles of coarse fibres traversing the section. In between the fibres, there were collections of tumour cells. The cells were round in shape with vacuolated cytoplasm and small dark nuclei pushed to the periphery of the cells. [Figure 3]
Although gliomas of the optic nerve are relatively uncommon, they should be considered in every case of proptosis in children. About 80 per cent of cases manifest themselves in the first decade of life although adults may be affected. Spaulding  observed that glioma of the optic nerve is essentially a disease of puberty, the average age being from 10 to 12 years; the youngest patient was seven months old while the oldest was 47 years. The age of the patient reported here is 18 years i. e. later part of second decade.
Prognosis of the tumour depends largely on the site and the age of the patient at which symptoms develop. Although the tumours are essentially benign in nature and do not give rise to metastasis, their local spread may eventually prove fatal from cerebral involvement. Even when the excision of the tumour is partial leaving some portion within the optic canal which could not be reached through orbital approach, no orbital recurrences have been reported.
A case of optic nerve glioma in a young man aged 18 years is presented.
|1||Duke-Elder, S., 1971, System of Ophthalmology. Henry Kimpton, London.|
|2||Spaulding W. L., 1958, Amer. J. Ophthal. 46, 654.|