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.