Surgical Management of Optic Pathway-Hypothalamic Gliomas: Institutional Experience and Systematic Review

Introduction: Optic pathway–hypothalamic gliomas (OPHGs) are rare, challenging lesions due to their deep location and proximity to critical visual, endocrine, and vascular structures. Treatment is multifactorial, and the role of surgical resection is still debated. This study presents our institutional surgical experience and a systematic review of the literature surrounding resection of OPHG, with an emphasis on surgical approach. Methods: We retrospectively reviewed all patients with OPHGs who underwent surgical resection at our institution between 2011 and 2025. Demographics, presentation, pathology, operative approach, extent of resection, complications, and outcomes were analyzed. A systematic review of surgically treated OPHGs was conducted per PRISMA guidelines (PubMed/EMBASE, 1946–2024). Pooled data were used to compare adult (≥18 years) and pediatric (