“…Historically, there has not been clear consensus over the role of biopsy at diagnosis and the start of therapy against optic pathway tumors, independent of NF1 status. If an optic glioma is highly suspected based on the MR imaging findings, that is included an iso-to hypointense lesion on T1-weighted images, a hyperintense lesion on T2-weighted images, and homogeneous enhancement or peripheral enhancement with Gd administration [3,15], because most optic gliomas are low-grade astrocytoma, biopsy or other surgical interventions are not recommended [18,20]. As recent trends, optic pathway tumors with these typical MR imaging findings as optic gliomas do not require biopsy or surgery, and initially, watch/wait/rescan policy should be adopted if the tumor is small and asymptomatic [3].…”