Evaluation and management of gliomas of the anterior visual pathways

Fifty-one patients seen at the Johns Hopkins Hospital between 1930 and 1973 with the diagnosis of “optic glioma” were re-evaluated. Of the 51 patients, 29 had biopsy-proven optic chiasmal gliomas, 11 had gliomas confined solely to the optic nerve, and 9 were diagnosed on the basis of clinical presentation, neuroradiological techniques, or from visual evidence of a chiasmal mass at craniotomy. Two incorrect pathological diagnoses were made despite adequate biopsy material. The signs, symptoms, course and prognoses of patients with chiasmal and nerve gliomas are compared and contrasted. On the basis of the study, suggestions are made for the diagnosis and management of patients with gliomas of the anterior visual pathways.