Optic pathway glioma and intracranial tumours
Management of optic pathway gliomas is controversial and challenging
because their clinical manifestation varies widely, from a relatively
benign clinical course, to significant morbidity4,13,42. The management of optic pathway gliomas
involves the spectrum from observation to surgery, chemotherapy and
radiotherapy. As it is so rare among black Africans, the best strategy
is as yet undetermined. Though, observation requires serial
neuro-imaging, this in itself, is a financial burden to many patients.
Serial visual evoked potentials, being much cheaper, have been advocated
by some authors, but this is also not readily available and also has
limitations 42,55. Following diagnosis, the patient is
either managed by the oncologist, orbital surgeon (if discrete) or
referred to the neurosurgeon. Existing guidelines are unclear as to the
subspecialty that is primarily responsible. Where a multidisciplinary
team exists, the expertise may be found within the team or an invitation
is extended to a specialist to join the group. A similar situation
exists with a patient who has an intracranial pathology in the setting
of a multisystem disorder such as NF.