Optic Nerve Glioma

These images show fusiform enlargement, T2 hyperintensity, and avid enhancement of the orbital segment of the right optic nerve. There is mild associated proptosis. Findings are compatible with optic nerve glioma in this pediatric patient with a history of neurofibromatosis type I. Syndromic cases of optic nerve glioma usually involve the anterior optic pathways, can be bilateral, and may follow a more indolent course with the possibility of spontaneous regression. Progression of the lesion usually occurs in the first two years following the diagnosis and syndromic cases are usually observed unless vision is threatened in which case chemotherapy is usually the initial treatment.