The management and prognosis of gliomas of the optic pathways in children.

A follow-up study was made of 24 children with gliomas of the optic pathways. In gliomas restricted to one optic nerve, total excision should be performed. The prognosis is excellent. Radiotherapy is not indicated. In gliomas of the anterior chiasma a biopsy should be taken; occasionally partial removal is indicated. The prognosis is good. Radiotherapy is indicated only if the follow-up shows a progression in the visual signs. In most cases the growth of the tumour seems to be arrested. The vision remains stable, and most patients have a useful degree of vision in at least one eye. In gliomas of the posterior chiasma with hypothalamic signs the prognosis is poor. A biopsy and radiotherapy are indicated. Occasionally, long remissions are seen.