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1- Department of Pediatric, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
2- Clinical Research Development Unit of Bu-Ali Sina Hospital, Department of Ophthalmology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran
3- Clinical Research Development Unit of Bu-Ali Sina Hospital, Department of Ophthalmology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran , ahmadzdh@yahoo.com
Abstract:   (332 Views)
Introduction: Melanocytoma is a rare benign stationary tumor that usually occurs as a pigmented lesion on the optic disk. Optic disk melanocytoma (ODM) can cause compression of the optic nerve or undergo necrosis, lead to ischemic axonal loss and visual field defect which can be similar to those caused by glaucoma. ODM also often displays a clinical diagnostic dilemma due to its similarities with melanoma. Some patients have been encountered enucleation because of uncertainty between both pathologies. Progressive growth and malignant transformation can be documented by close monitoring of patient eyes. Fundus examination and ancillary imaging procedures such as fundus photo, autofluorescence, B-scan ultrasonography, fluorescein angiography, and spectral-domain optic coherence tomography are substantial tools for diagnosis and management.
Case presentation: A 19-year-old female presented with a known decrease in vision in the left eye for about 3 months. Her visual acuity was 20/20 and 20/80 in her right and left eyes, respectively. Funduscopic examination of the left eye showed a well-defined deeply pigmented brownish-black, dome-shaped nodular mass involved the entire optic disc with the normal-appearing overlying vitreous, macula, and surrounding retina. Short-wave autofluorescence (SW-AF) revealed hypo-autofluorescence on the pigmented mass lesion. The patient's condition did not change significantly over 2 years of follow-up. The diagnosis was made as ODM.
Conclusions: Melanocytomas grow very slowly over several years or remains stable, in contrast to malignant melanoma. Although optic disc melanocytomas tend to be benign behavior, they may adversely affect visual function. Yearly fundus examination is necessary for monitoring growth and detecting malignant transformation. Visual loss can be induced by optic neuropathy or retinal vascular obstruction. In suspicious cases, close follow-up with serial fundus photographs is essential, even though the malignant transformation is exceptional.
Full-Text [PDF 839 kb]   (71 Downloads)    
Type of Study: Case Report and Review of Literature | Subject: Ophthalmology
Received: 2019/10/5 | Accepted: 2019/12/4

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