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Radiation therapy a plausible strategy in optic nerve sheath meningioma
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CHICAGO — Because optic sheath meningioma is a slowly progressing, benign ophthalmic tumor, careful monitoring should be the first line of management, but when treatment is called for, fractionated stereotactic radiotherapy can be highly effective, according to a speaker here.
 Peter J. Savino |
Optic sheath meningioma accounts for about 2% of orbital tumors, occurring more frequently in women, Peter J. Savino, MD, said at the joint meeting of the American Academy of Ophthalmology and Middle East Africa Council of Ophthalmology. Optic sheath meningioma has been historically managed through observation only, but once the meningioma sets in, virtually all patients will experience visual loss, Dr. Savino said.
Surgical removal of the mass is not effective due to long-term complications from the operation, Dr. Savino said. Although the mass is slow growing and benign, radiation reduces the size of the meningioma, he said.
Typical radiotherapy in optic sheath meningioma carries a high complication risk. However, an institutional study in 65 patients followed for 156 months at Wills Eye Hospital demonstrated that "fractionated stereotactic radiotherapy was quite effective in these people in preventing further visual loss or actually improving vision."
"Equally as important," Dr. Savino said, "was that the complication rate was quite low."