Optic pathway gliomas are generally indolent, however significant progression occurs in as many as 75-85% of patients.
This growth is usually within 2 years of the initial diagnosis.
Children with neurofibromatosis tend to have a slower rate of progression as well as a longer latency interval.
Mortality with this tumor is uncommon within 10 years of diagnosis.
Spontaneous regression has been documented with optic nerve gliomas.
There is a greater than 90% chance of survival after surgical resection when glioma has been limited to the optic nerve. However, when the tumor extends to the optic chiasm or beyond, the prognosis worsens.
Regardless of NF status, for optic nerve-only involvement, complete resection is associated with a 90% or so survival at 15 years
Outcome after surgery-only for posterior (chiasmatic/hypothalamus) lesions is less
favorable (only 41% have a 10-year relapse-free survival).
Untreated lesions have a 50% mortality rate.
After radiation, the survival rate increases to 60-100%. Improved vision occurs in 30-40% of patients after radiation therapy.