Neurofibromatosis type 1 (NF1) is associated with peripheral and central nervous system tumors. It is noteworthy that the regions in which these tumors frequently arise are the optic pathways (OPs) and the brainstem. Thus, we decided to trace the procedure of diffusion Magnetic Resonance Imaging (dMRI) alterations along with Short-Wavelength Automated Perimetry (SWAP) examinations of the OPs after surgery and chemotherapy over one year, which enabled us to evaluate chemotherapy's efficacy in an NF1 patient with an OP tumor. In this study, a 25-year-old woman with NF1 and left optic radiation (OR) glioma underwent surgery to remove the glioma. Immunohistochemistry (IHC) revealed a Pilocytic Astrocytoma (PA) WHO grade I. Post-operation chemotherapy done using nine treatment cycles of administering Temozolomide (TMZ) for five days every four weeks. Applying the region of interest (ROI) differential tractography method and SWAP four times every three months allowed us to follow the patient's visual acuity alterations longitudinally. The differential deterministic tractography method and statistical analyses enabled us to discover the white matter (WM) tracts anisotropy alterations over time. Furthermore, statistical analyses on the SWAP results along time illustrated possible alterations in visual acuity. Then, we could compare and associate the findings with the SWAP examinations and patient symptoms longitudinally. Statistical analyses on SWAP tests revealed a significant improvement in visual fields, and also, longitudinal differential tractography showed myelination and dense axonal packing in the left OR after one year of treatment. In this study, we examined an old hypothesis suggesting that chemotherapy is more effective than radiotherapy for NF1 patients with OP gliomas (OPGs) because of the radiation side effects on the visual field, cognition, and cerebrovascular complications. Our longitudinal clinical case study involving dMRI and SWAP on a single NF1-OPG patient showed that chemotherapy did not suppress the OP myelination over time. However, it should be noted that this is a clinical case study, and therefore, generalization of results is limited. Future investigations might focus on genetic-based imaging, particularly in more cases. Further, meta-analyses are recommended for giving a proper Field Of View (FOV) to researchers as a subtle clue regarding precision medicine.

中文翻译：

---

病例报告：1例神经纤维瘤病呈光学通路神经胶质瘤的化疗指征：使用微分牵引术的一年期临床病例研究

1型神经纤维瘤病（NF1）与周围和中枢神经系统肿瘤相关。值得注意的是，这些肿瘤经常出现的区域是光通路（OPs）和脑干。因此，我们决定追踪手术和化疗一年后OP的扩散磁共振成像（dMRI）改变以及OP的短波自动视野检查（SWAP）检查的过程，从而使我们能够评估NF1患者化疗的疗效患有OP肿瘤。在这项研究中，一名患有NF1和左视辐射（OR）神经胶质瘤的25岁妇女接受了手术以去除神经胶质瘤。免疫组织化学（IHC）显示世界卫生组织I级恶性星形细胞瘤（PA）。术后化疗使用九个治疗周期进行，每四个星期施用替莫唑胺（TMZ）五天。每三个月应用四次感兴趣区域（ROI）差分束线照相法和SWAP，使我们能够纵向观察患者的视敏度变化。差分确定性束摄影方法和统计分析使我们能够发现白质（WM）道随时间变化的各向异性。此外，对随时间变化的SWAP结果的统计分析说明了视力可能发生了变化。然后，我们可以将调查结果与SWAP检查和患者症状进行纵向比较和关联。对SWAP测试的统计分析表明，视野得到了显着改善，此外，纵向差异束摄影显示治疗一年后左手术室有髓鞘化和浓密的轴突堆积。在这项研究中，我们检查了一个古老的假设，即对于放疗神经胶质瘤（OPGs）的NF1患者，由于其对视野，认知和脑血管并发症的放射副作用，化疗比放疗更有效。我们对一名NF1-OPG患者进行的涉及dMRI和SWAP的纵向临床案例研究表明，随着时间的推移，化学疗法并不能抑制OP髓鞘形成。但是，应注意，这是一个临床案例研究，因此，结果的推广受到限制。未来的研究可能会集中在基于遗传的成像上，尤其是在更多情况下。进一步，