Optic Nerve Sheath Meningiomas: A Narrative Review of Clinical Features, Imaging Advances, and Current Management
- 1Department of Ophthalmology, The Orbital Center, Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands
- 2Department of Ophthalmology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
Abstract
Optic nerve sheath meningioma (ONSM) is a rare orbital tumor that can pose a significant threat to visual function due to its close relationship with the optic nerve and surrounding vascular structures. Early and accurate diagnosis is essential to preserve vision and guide individualized management. The objective of this narrative review is to provide a comprehensive overview of the current evidence on the clinical presentation, diagnostic evaluation, imaging characteristics, and management of ONSM, with a particular focus on recent advances in imaging techniques and their implications for clinical decision-making. This review synthesizes current knowledge on clinical presentation, diagnostic workup, and evolving treatment strategies for ONSM, with particular emphasis on advanced imaging modalities. Magnetic resonance imaging remains the cornerstone of diagnosis, yet functional imaging, especially somatostatin receptor-–based techniques such as 68GaDOTATATE PET/CT have shown potential as a useful adjunct in the diagnostic evaluation of ONSM, especially for assessing tumor characteristics, extent, and treatment planning in selected cases. We discuss the emerging role of DOTATATE imaging in differentiating ONSM from other optic nerve and orbital pathologies, as well as its potential application in monitoring therapeutic response. We also highlight contemporary management approaches, including fractionated radiotherapy and the selective role of surgical intervention, underscoring the importance of multidisciplinary decision-making in optimizing visual outcomes. Emerging molecular insights from meningioma research may inform future therapeutic strategies for ONSM; however, clinical evidence specific to ONSM remains limited.
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BibTeX
@article{sadeghi2026optic,
title = {{Optic Nerve Sheath Meningiomas: A Narrative Review of Clinical Features, Imaging Advances, and Current Management}},
author = {Nima Sadeghi and Kamil Laban and Peerooz Saeed},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18203405},
url = {https://www.mdpi.com/2072-6694/18/20/3405},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Optic Nerve Sheath Meningiomas: A Narrative Review of Clinical Features, Imaging Advances, and Current Management
AU - Nima Sadeghi
AU - Kamil Laban
AU - Peerooz Saeed
PY - 2026
DA - 2026/10/01
JO - Cancers
DO - 10.3390/cancers18203405
UR - https://www.mdpi.com/2072-6694/18/20/3405
AB - Optic nerve sheath meningioma (ONSM) is a rare orbital tumor that can pose a significant threat to visual function due to its close relationship with the optic nerve and surrounding vascular structures. Early and accurate diagnosis is essential to preserve vision and guide individualized management. The objective of this narrative review is to provide a comprehensive overview of the current evidence on the clinical presentation, diagnostic evaluation, imaging characteristics, and management of ONSM, with a particular focus on recent advances in imaging techniques and their implications for clinical decision-making. This review synthesizes current knowledge on clinical presentation, diagnostic workup, and evolving treatment strategies for ONSM, with particular emphasis on advanced imaging modalities. Magnetic resonance imaging remains the cornerstone of diagnosis, yet functional imaging, especially somatostatin receptor-–based techniques such as 68GaDOTATATE PET/CT have shown potential as a useful adjunct in the diagnostic evaluation of ONSM, especially for assessing tumor characteristics, extent, and treatment planning in selected cases. We discuss the emerging role of DOTATATE imaging in differentiating ONSM from other optic nerve and orbital pathologies, as well as its potential application in monitoring therapeutic response. We also highlight contemporary management approaches, including fractionated radiotherapy and the selective role of surgical intervention, underscoring the importance of multidisciplinary decision-making in optimizing visual outcomes. Emerging molecular insights from meningioma research may inform future therapeutic strategies for ONSM; however, clinical evidence specific to ONSM remains limited.
SN - 2072-6694
ER -