Optic pathway gliomas (OPGs) are among the low-grade tumors restricted intrinsic to the optic nerve, optic chiasm, tracts, and radiations. These neoplasms are associated with NF1 mutation and occur more commonly in children than adolescents and adults. Being deep in the white matter tract reduces the possibility of surgical resection or even stereotactic biopsy for definite diagnosis, unless there is a sizable extrinsic component. As a result, a combination of clinical symptomatology, MRI features and presence of NF mutation are taken for diagnosis in most cases. Advanced neuroimaging techniques such as diffusion tractography of optic nerve continue to evolve, nonetheless, they may be challenging as the nerve is small in size and orbit motions can affect the quality of images. The optimum management of OPG has also remained controversial for many years and over several generations of neurosurgeons. The literature suggestions for this entity range between close observation of minimally or not symptomatic patients to chemotherapy as the accepted first line treatment in symptomatic patients, while surgical interventions are reserved for conditions like hydrocephalus, tumor progression despite chemotherapy, and complete visual loss accompanied with proptosis.
Taken together, no consensus is available for diagnosis approach, follow-up technique, and treatment modalities for OPGs. Besides, there is no convincing evidence for association between imaging features of the tumor and likelihood of progression. The scientific societies of various disciplines, including neurosurgery, neuro-ophthalmology, neuroradiology, neuro-oncology, and neuropsychology have run sophisticated studies and take serious efforts to delineate this grey part of neurological surgery. In this issue of the Neurosurgery section, we aim to focus upon different aspects of this multidisciplinary entity.
The intent of this issue is to provide a contemporary update including the diagnostic methods, genetic investigations, algorithms to guide conservative, medical or surgical management, and the proposed surveillance timetable. This issue also focuses on the evaluations of current evidence regarding the outcome of current treatments and recent recommendations to raise awareness on the surgeon’s role in the management of OPG. Submissions of the various article types including; Case Report, Clinical Trial, Original Research, General Commentary, Review, Study Protocol, Systematic Review, and other types of papers are welcomed. The subject of the submitted manuscript must fit to the OPG topic; if it does not, the submission will not be processed for peer review. New submissions should be prepared following the Instructions for Authors.
Optic pathway gliomas (OPGs) are among the low-grade tumors restricted intrinsic to the optic nerve, optic chiasm, tracts, and radiations. These neoplasms are associated with NF1 mutation and occur more commonly in children than adolescents and adults. Being deep in the white matter tract reduces the possibility of surgical resection or even stereotactic biopsy for definite diagnosis, unless there is a sizable extrinsic component. As a result, a combination of clinical symptomatology, MRI features and presence of NF mutation are taken for diagnosis in most cases. Advanced neuroimaging techniques such as diffusion tractography of optic nerve continue to evolve, nonetheless, they may be challenging as the nerve is small in size and orbit motions can affect the quality of images. The optimum management of OPG has also remained controversial for many years and over several generations of neurosurgeons. The literature suggestions for this entity range between close observation of minimally or not symptomatic patients to chemotherapy as the accepted first line treatment in symptomatic patients, while surgical interventions are reserved for conditions like hydrocephalus, tumor progression despite chemotherapy, and complete visual loss accompanied with proptosis.
Taken together, no consensus is available for diagnosis approach, follow-up technique, and treatment modalities for OPGs. Besides, there is no convincing evidence for association between imaging features of the tumor and likelihood of progression. The scientific societies of various disciplines, including neurosurgery, neuro-ophthalmology, neuroradiology, neuro-oncology, and neuropsychology have run sophisticated studies and take serious efforts to delineate this grey part of neurological surgery. In this issue of the Neurosurgery section, we aim to focus upon different aspects of this multidisciplinary entity.
The intent of this issue is to provide a contemporary update including the diagnostic methods, genetic investigations, algorithms to guide conservative, medical or surgical management, and the proposed surveillance timetable. This issue also focuses on the evaluations of current evidence regarding the outcome of current treatments and recent recommendations to raise awareness on the surgeon’s role in the management of OPG. Submissions of the various article types including; Case Report, Clinical Trial, Original Research, General Commentary, Review, Study Protocol, Systematic Review, and other types of papers are welcomed. The subject of the submitted manuscript must fit to the OPG topic; if it does not, the submission will not be processed for peer review. New submissions should be prepared following the Instructions for Authors.
