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Case Reports
. 2020 Apr 7;13(4):e234014.
doi: 10.1136/bcr-2019-234014.

Visual field fluctuations correlating with the menstrual cycle in a patient with optic pathway glioma

Adam Jacobson  1 , Marcia Leonard  2 , Patricia Robertson  2 , Brenda L Bohnsack  3
Affiliations
Case Reports

Visual field fluctuations correlating with the menstrual cycle in a patient with optic pathway glioma

Adam Jacobson et al. BMJ Case Rep. .

Abstract

Optic pathway gliomas are commonly associated with vision loss in children. We describe an 18-year-old woman with neurofibromatosis, type 1 and an optic nerve glioma who showed reproducible visual field defects that worsened midmenstrual cycle and returned to baseline during menses. To our knowledge, this is the first reported case of visual field fluctuations in a patient with an optic nerve glioma that correlated with her menstrual cycle.

Keywords: CNS cancer; neurooncology; visual pathway.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Baseline clinical characteristics. (A) Pattern deviation plots of Humphrey visual field testing at 12 years of age showed inferior arcuate and early superior arcuate defects. At 13 years of age, worsening of the superior and inferior arcuate defects with correlative decreases in Visual Field Index (VFI) and mean deviation (MD) precipitated initiation of lenalidomide treatment. Following two courses (30 total cycles over 4 years) of lenalidomide, there was improvement of the arcuate defects, VFI, MD and pattern SD (PSD). (B) At 18 years of age, the right optic nerve was pale with thinning of the retinal nerve fibre layer compared with the left optic nerve. G, Global; N, Nasal; NI, Inferior-Nasal; NS, Superior-Nasal; N/T, Nasal:Temporal Ratio; PMB, perimacular bundle; T, Temporal; TI Inferior-Temporal; TS Superior-Temporal.
Figure 2
Figure 2
Visual field fluctuations correlated with menstrual cycle worsening of the inferior arcuate and early superior arcuate defects with associated decreases in Visual Field Index (VFI) and mean deviation (MD) were detected midcycle at ovulation when oestrogen levels are highest. The visual fields improved during menses when oestrogen levels are lowest. PSD, pattern SD.
See this image and copyright information in PMC

References

    1. Listernick R, Charrow J, Greenwald M, et al. . Natural history of optic pathway tumors in children with neurofibromatosis type 1: a longitudinal study. J Pediatr 1994;125:63–6. 10.1016/S0022-3476(94)70122-9 - DOI - PubMed
    1. Avery RA, Fisher MJ, Liu GT. Optic pathway gliomas. J Neuroophthalmol 2011;31:269–78. 10.1097/WNO.0b013e31822aef82 - DOI - PubMed
    1. Packer RJ, Ater J, Allen J, et al. . Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas. J Neurosurg 1997;86:747–54. 10.3171/jns.1997.86.5.0747 - DOI - PubMed
    1. Nicolin G, Parkin P, Mabbott D, et al. . Natural history and outcome of optic pathway gliomas in children. Pediatr Blood Cancer 2009;53:1231–7. 10.1002/pbc.22198 - DOI - PubMed
    1. Fisher MJ, Loguidice M, Gutmann DH, et al. . Visual outcomes in children with neurofibromatosis type 1-associated optic pathway glioma following chemotherapy: a multicenter retrospective analysis. Neuro Oncol 2012;14:790–7. 10.1093/neuonc/nos076 - DOI - PMC - PubMed

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