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Optic nerve tumor pathology – melanocytoma

Description

55-year-old asymptomatic woman who comes for a check-up.

Visual acuity is 20/20 in both eyes. The fundus of the right eye reveals a dark brown superficial lesion on the optic nerve head with well-defined borders. The lesion is hypoautofluorescent with green AF. OCT shows no intra- or perilesional exudative signs and a superficial lesion with posterior shadowing. The diagnosis of optic nerve melanocytoma is made. After 5 years of follow-up, no growth or changes in the appearance of the lesion are observed.

Comments

Melanocytoma is a rare benign neoplasm that usually affects the optic nerve head, although it can affect the retina and adjacent choroid. It is believed to be a congenital and not hereditary lesion and its importance lies in the differential diagnosis with other neoplasms such as melanoma and choroidal nevus. It is a homogeneous pigmented mass in the optic nerve head that shows a complete absence of autofluorescence. OCT shows a nodular elevation with an intense posterior shadow, areas of irregular hyperreflectivity over the tumor and even fine hyperreflective lines outlining the vessels and the anterior surface of the tumor.

Indication