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Response To Radiotherapy Of Optic Nerve Sheath Meningiomas
  1. Robert L Lesser1,*,
  2. Jonathan P.S. Knisely1,
  3. Mark J. Kupersmith2,
  4. Silas L Wang1,
  5. James B. Yu1
  1. 1 Yale University School of Medicine, United States;
  2. 2 New York Eye and Ear and Roosvelt Hospital, Albert Eistein College of Medicine, United States
  1. Correspondence to: Robert L Lesser, Ophthalmology & Visual Science & Neurology, Yale University School of Medicine, 40 Temple Street, New Haven, 06510, United States; rlesser4{at}


Background/Aims: To review the long term results of treatment of optic nerve sheath meningiomas (ONSM) with conformal radiotherapy.

Methods: Eleven patients with presumed ONSM were treated with fractionated conformal radiotherapy using 45 to 54 Gy in 25 to 29 fractions and followed for more than 5 years. Affected eye visual acuity in LogMar notation, color vision, threshold perimetry, mean deviation (db), and imaging were studied before and after treatment.

Analysis: Included adverse effects of treatment and the frequency of affected eye maintained or improved vision.

Results: There were 9 women and 2 men with a mean age of 45.3. Vision or field loss was the most common presentation. All had abnormal MR imaging. Follow-up period after radiotherapy was 61 to 156 months (mean 89.6). Visual acuity was unchanged or improved in 10 patients(91%). The average difference between pre-treatment and final LogMar visual acuity was 0.08, while average difference in visual field mean deviation was -4.63 dB. The radiographic appearance of the tumors was stable in size in 9 patients and decreased in 2. No major side effects from radiation were seen.

Conclusions: Vision, MRI, and complication outcomes are favorable for using fractionated conformal radiotherapy for ONSM.

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