Optic Pathway Glioma

Optic Pathway Glioma (OPG) is a type of slow-growing brain tumor that affects the optic nerves, optic chiasm, and sometimes extends to the hypothalamus or brainstem. Most commonly seen in children under the age of 10, OPGs are typically low-grade gliomas, usually classified as pilocytic astrocytomas. In Bangladesh, optic pathway gliomas often go undiagnosed or misdiagnosed, especially in rural settings, due to subtle early symptoms and lack of routine eye screenings in children. With increasing awareness and access to pediatric neurosurgery in Dhaka, more children are now receiving timely care under specialists like Dr. Md. Nafaur Rahman. 🧬 Who is at Risk? Children between ages 1 and 10 are most commonly affected. Around 15–20% of children with Neurofibromatosis Type 1 (NF1) develop OPG. The condition may be sporadic or associated with genetic disorders. Early diagnosis is key to preserving vision and preventing neurological decline. 🔍 Symptoms of Optic Pathway Glioma OPGs often develop gradually, so symptoms may not be obvious at first. Key warning signs include: Progressive vision loss in one or both eyes Nystagmus (involuntary eye movement) Proptosis (bulging of one eye) Strabismus (crossed eyes or misalignment) Delayed development or learning difficulties Hormonal changes (if the tumor affects the hypothalamus or pituitary gland) Headache, vomiting, or drowsiness (if there is hydrocephalus) In Bangladesh, such symptoms are often misinterpreted as eye infection, trauma, or normal developmental delay, leading to late referrals. 🧪 Diagnosis: Early & Accurate is Critical A child presenting with unexplained vision loss or eye movement issues should undergo prompt neuroimaging and neurological evaluation. Diagnostic Tools Used: MRI of Brain and Orbits with Contrast – Gold standard to visualize tumor extent and involvement Visual Field Testing – Assesses the severity and progression of vision loss Endocrine Evaluation – If there are signs of hormonal dysfunction Genetic Testing – For NF1 (if clinical signs are present) Ophthalmologic Review – Essential for baseline vision documentation At NINS and Bangladesh Paediatric Neurocare Centre, children undergo a complete diagnostic protocol supervised by Dr. Md. Nafaur Rahman and his team of pediatric neuro-specialists. 🧠 Treatment of Optic Pathway Glioma in Children Management depends on: Tumor location and size Degree of vision loss Rate of progression NF1 status Presence of hypothalamic involvement or hydrocephalus 🔧 Treatment Options: Observation Only For small, non-progressive tumors in NF1 patients Requires regular MRI and vision follow-up Chemotherapy Mainstay of treatment in most symptomatic or growing OPGs Used to delay or avoid radiation in young children Standard regimens include Vincristine and Carboplatin Surgical Intervention Reserved for cases with: Severe proptosis Vision-threatening mass effect CSF obstruction (hydrocephalus) Rapid growth in non-NF1 cases Procedures may include: Tumor debulking CSF diversion (shunt or endoscopic third ventriculostomy) “Surgery for optic pathway glioma must be approached with great caution. Our goal is to relieve symptoms while preserving as much neurological and visual function as possible.” — Dr. Md. Nafaur Rahman Radiotherapy Considered for older children with recurrent or progressive tumors Avoided in very young children due to risk of long-term cognitive and hormonal side effects 🌈 Long-Term Outcomes & Follow-Up Care Most OPGs are slow-growing, but their impact can be significant due to their location. Long-term monitoring is essential. Regular Follow-Up Includes: MRI scans every 3–6 months Ophthalmologic assessments for vision tracking Neuro-endocrine monitoring Rehabilitation and counseling for developmental support Genetic counseling for NF1 families With modern treatment, many children can maintain useful vision, attend school, and live a relatively normal life. 🇧🇩 Bangladesh Perspective: Urgent Need for Awareness In Bangladesh, OPG is often missed until advanced stages, especially outside major urban centers. Challenges include: Low awareness among pediatricians and ophthalmologists Lack of routine vision screening in schools Misconceptions about eye problems in infants Limited MRI access in rural districts Financial burden for families Dr. Md. Nafaur Rahman is committed to changing this landscape by: Providing affordable, world-class pediatric neurosurgical care Educating frontline doctors to recognize early signs Coordinating with pediatric oncologists and ophthalmologists Offering long-term care for NF1 patients at risk 👨‍⚕️ Why Choose Dr. Md. Nafaur Rahman? 🧠 Renowned expert in pediatric brain and optic pathway tumors 🏥 Operates at NINS and Bangladesh Paediatric Neurocare Centre 🧬 Offers multidisciplinary care with oncology, ophthalmology, and endocrinology 📊 Delivers evidence-based treatment tailored to the child’s needs 💯 Proven record of successful outcomes in complex OPG cases 📞 Contact for Pediatric Optic Pathway Glioma Evaluation Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📱 For Serial/Appointment: 01912988182 | 01607033535 🌐 Website: www.neurosurgeonnafaur.com