Treatments of Optic Nerve Sheath Meningioma
Because the main effect of ONSM is vision loss, the goal of treatment is to preserve vision. Hence, treatment is recommended in cases of progressive vision loss. Observation can be warranted if the tumor is small and not affecting vision, but the patient should be monitored closely with regular follow-ups.
Current preferred treatment modality is radiation therapy, with reported preservation of vision in more than 80% of cases. Surgical resection almost always causes vision loss and is reserved for blind, painful eyes or in cases of progressive changes concerning for cancer.