Previously, Sugita and Kageyama proposed that optic gliomas in childhood could be classified into two groups, namely infant type and child type. Infant type tumors, which were often seen in infants or younger children, were usually large in size and severely invaded the hypothalamus in the early stage of their courses. Thus, their prognosis was very poor. Histologically, this infant type was considered to be immature astrocytoma. On the other hand, child type tumors, which affected usually older children, were relatively localized to the optic pathway and rather self-limited in growth. Histologically, they belonged to mature astrocytoma.
In the present study, 11 cases of verified optic glioma (4 infant type and 7 child type) were studied. The association with neurofibromatosis was recognized in 2 cases. Three out of 4 infant type cases died shortly after surgery mainly due to hypothalamic dysfunction. All of the other 8 cases (1 infant type and 7 child type) have survived and were followed-up. Only one survivor of the infant type was alive 10 years after the onset but severely disabled. Two out of 7 child type cases were cases of unilateral optic nerve glioma. In both, the tumors were resected totally and have shown no signs of recurrence. Five cases of child type tumor with chiasmal involvement, who underwent partial removal or biopsy alone, were closely studied. The follow-up period of each case ranged from 8 to 12 years. In 10 eyes of these 5 cases, 7 had useful visual acuity (0.02 or better) before surgery. At the time of present study, 5 of these 7 eyes (71 %) had been either unchanged or improved in each visual acuity. All of these 5 cases were leading a mainly normal student life taking various educational courses. None of the 3 patients who were followed-up by computerized tomography scan for a period of 4 years showed any evidence of enlargement of tumors.
These results support the previous notion that optic gliomas of child type had a rather benign course and good prognosis.