Magnetic Resonance Imaging Evidence of Optic Nerve Glioma Progression Into and Beyond the Optic Chiasm

In Brief Optic nerve glioma has been a topic of great interest and controversy, particularly with respect to its tendency to invade the optic chiasm. This case report demonstrates histologically verified optic nerve glioma in an otherwise healthy 5-year-old girl. MRI revealed sequential prechiasmal, chiasmal, and postchiasmal disease during the untreated course of 18 months. The authors also discuss the results obtained with a specific immunohistochemical technique, the mindbomb homolog 1 (MIB-1) labeling index, and speculate that this information, if known early in the course of disease, might influence early surgical decision-making. The authors document MRI progression of optic nerve glioma from prechiasmal to postchiasmal disease and briefly discuss the role of specific immunohistochemical staining in the prognostication and management of optic nerve glioma.