Lin Chia-Ying, Huang Hsiu-Mei
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta-Pei Road, Kaohsiung, Taiwan.
BMC Ophthalmol. 2017 Mar 11;17(1):21. doi: 10.1186/s12886-017-0415-5.
Malignant optic gliomas are rare, but they rapidly become lethal visual pathway tumors. We present the clinical course, treatment, and prognosis of a case of unilateral malignant optic glioma in a young man with a history of brain glioblastoma multiforme (GBM).
A 21-year-old man, who had GBM 7 years ago complained of a transient shadow in his vision and presented with normal visual acuity but optic disc edema and an enlarged blind spot in the right eye (oculus dexter, OD). Magnetic resonance imaging (MRI) showed a right intraorbital optic nerve tumor without a brain lesion. Chiasm involvement and severe vision deterioration occurred 3 months later. A biopsy of the right optic nerve revealed glioblastoma. Concurrent chemoradiotherapy (CCRT) prevented involvement of the fellow eye 1 year after symptom onset.
This report demonstrated that a regular ocular exam should be recommended for several years after GBM. In young healthy patients who are able to undergo chemotherapy and radiotherapy, visual function in the fellow eye can be preserved.
恶性视神经胶质瘤较为罕见，但它们会迅速成为致命的视觉通路肿瘤。我们报告了一名有多形性胶质母细胞瘤（GBM）病史的年轻男性单侧恶性视神经胶质瘤的临床病程、治疗及预后情况。
一名21岁男性，7年前患GBM，主诉视力有短暂阴影，就诊时视力正常，但右眼视盘水肿且盲点扩大。磁共振成像（MRI）显示右侧眶内视神经肿瘤，无脑部病变。3个月后出现视交叉受累及严重视力恶化。右侧视神经活检显示为胶质母细胞瘤。症状出现1年后，同步放化疗（CCRT）预防了对侧眼受累。
本报告表明，GBM患者在数年内应建议定期进行眼科检查。对于能够接受化疗和放疗的年轻健康患者，对侧眼的视觉功能可以得到保留。
