Long-term visual outcome in patients with anterior visual pathway gliomas

Objectives: To investigate the visual outcomes of patients with gliomas of the anterior visual pathway and the clinical features associated with progn osis. Materials and Methods: During retrospective review, demographic and clinica l data were abstracted from medical records of patients seen at the Bascom Palmer Eye Institute between January 1, 1970 and December 31, 1998. Results: Of the 42 patients identified, 68% were female, and 55% had neurof ibromatosis (NF) type I. There was no substantial difference in presenting signs, symptoms, and visual acuity between the NF(+) and NF(-) groups excep t for nystagmus, which was more common in the NF(-) group (p = 0.014). Thro ughout follow-up evaluation, vision in the better eye remained stable in bo th groups, independent of treatment or NF status. Vision in the worse eye o ften declined, despite treatment. However, binocular visual status, measure d as average weighted logMAR (MAR, minimum angle of resolution) vision, did not change significantly over time, regardless of treatment or NF status. Conclusions: In the NF(+) and NF(-) groups, vision in the better eye remain ed stable. regardless of treatment, and vision in the worse eye often decli ned, despite treatment. Binocular visual acuity (measured as weighted logMA R) did not change significantly over time, regardless of NF status or treat ment modality.