Atypical Optic Neuritis Mimicking Adult Glioma of the Anterior Visual Pathway

Adult optic nerve glioma can masquerade as optic neuritis, until the atypical clinical course and neuroimaging features are recognized.1 Similarly, demyelinating disease can rarely mimic malignant optic nerve glioma, with enhancement and enlargement of the chiasm and anterior visual pathway. We describe two patients with atypical optic neuritis who were erroneously diagnosed with malignant optic nerve glioma when they presented with progressive vision loss and impressive enlargement of the optic nerve and chiasm on neuroimaging.