Landert Monika, Baumert Brigitta G, Bosch Martina M, Lütolf Urs M, Landau Klara
Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.
J Neuroophthalmol. 2005 Jun;25(2):86-91. doi: 10.1097/01.wno.0000165105.78365.22.
Treatment of primary optic nerve sheath meningiomas (ONSMs) remains controversial. Although recent studies have suggested a favorable outcome of radiotherapy, controlled data on the efficacy of fractionated stereotactic conformal radiotherapy (SCRT) in primary ONSMs are still lacking.
Seven eyes treated with SCRT (total dose: 54 Gy) were compared with six eyes that were not treated because of patient or physician preference. The indication for intervention was deterioration of visual function with or without imaging evidence of tumor progression. Patients with secondary ONSMs and those with neurofibromatosis type 2 were excluded. The mean follow-up period was 57 months for the treated eyes and 61 months for the untreated eyes.
Among the seven treated eyes, visual acuity improved in six, five of which sustained improvement of three or more Snellen lines. One eye deteriorated by two lines. Visual field improved in four eyes, remained stable in two, and deteriorated in one. Four untreated eyes showed worsening of visual acuity and two remained stable. Visual field deteriorated in three eyes and was stable in three. None of the untreated eyes experienced improvement in visual acuity or visual field. No complications of treatment were documented.
In agreement with previous reports, these results indicate that SCRT is superior to observation in its impact on visual function in eyes with primary ONSMs.
原发性视神经鞘膜瘤（ONSMs）的治疗仍存在争议。尽管最近的研究表明放射治疗有良好的效果，但关于分次立体定向适形放疗（SCRT）治疗原发性ONSMs疗效的对照数据仍然缺乏。
将7只接受SCRT治疗（总剂量：54 Gy）的眼睛与6只因患者或医生偏好未接受治疗的眼睛进行比较。干预的指征是视功能恶化，无论有无肿瘤进展的影像学证据。排除继发性ONSMs患者和2型神经纤维瘤病患者。治疗组眼睛的平均随访期为57个月，未治疗组眼睛的平均随访期为61个月。
在7只接受治疗的眼睛中，6只视力提高，其中5只视力持续提高3行或更多Snellen行。1只眼睛视力下降2行。4只眼睛视野改善，2只稳定，1只恶化。4只未治疗的眼睛视力恶化，2只稳定。3只眼睛视野恶化，3只稳定。未治疗的眼睛均未出现视力或视野改善。未记录到治疗并发症。
与先前的报告一致，这些结果表明SCRT在对原发性ONSMs患眼视功能的影响方面优于观察。
