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OPHTHALMIC IMAGE |
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Year : 2020 | Volume
: 58
| Issue : 4 | Page : 322-323 |
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Pigmented optic disc lesion: A melanoma masquerade
Zeba Muzammil Shaikh, V Muthukrishnan, Shravya Choudhary Balla
Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
Date of Submission | 25-Jun-2020 |
Date of Decision | 20-Jul-2020 |
Date of Acceptance | 04-Aug-2020 |
Date of Web Publication | 16-Dec-2020 |
Correspondence Address: Dr. V Muthukrishnan No. 114, Inner Ring Road, Flat A4, Triumph Apartments, Arumbakkam, Chennai - 600 106, Tamil Nadu India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/tjosr.tjosr_79_20

A 67-year-old male was diagnosed with a pigmented lesion on the optic disc. Optic disc melanocytoma (ODM) is a rare benign, nonprogressive, heavily pigmented lesion arising from the melanocytes of the optic disc. The archetypal characteristics include dark pigmentation, feathery borders, and obscuration of the optic disc. It may be indistinguishable from choroidal melanoma occasionally. A regular follow-up with fundus photography is needed for early diagnosis of unusual complications.
Keywords: Benign nonprogressive pigmented lesion, jet-black pigmented lesion, optic disc melanocytoma
How to cite this article: Shaikh ZM, Muthukrishnan V, Balla SC. Pigmented optic disc lesion: A melanoma masquerade. TNOA J Ophthalmic Sci Res 2020;58:322-3 |
Introduction | |  |
Optic disc melanocytoma (ODM) is a benign hamartoma arising from the melanocytes in the lamina cribrosa, which presents as a jet-black lesion obscuring the disc and peripapillary choroid.[1] It is commonly diagnosed incidentally, in the sixth decade with female preponderance. It can lead to vision-threatening complications such as optic neuropathy, spontaneous tumor necrosis, choroidal neovascularization, cystoid macular edema, retinal traction, retinal vascular occlusion, and malignant transformation.[2] ODM should be differentiated from pigmented lesions such as nevus and melanoma.[2] Enlarged blind spot and altitudinal defects have been reported.[3]
Case Report | |  |
A 67-year-old male on routine fundus examination was found to harbor a heavily pigmented jet-black lesion in the left optic disc inferotemporally, sized two disc diameters with feathery borders [Figure 1]. | Figure 1: Left eye fundus photography revealing a jet-black lesion with feathery borders inferotemporally on optic disc
Click here to view |
Conclusion | |  |
ODM has typical characteristics but may mimic malignant melanoma clinically. Although known for its benign nature, a vigilant follow-up and photographic documentation is indispensable to monitor stability of lesion.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | |  |
1. | Singh SR, Mehta A, Dogra M, Dogra MR. Melanocytoma of the optic disc-Clinical spectrum. Indian J Ophthalmol 2019;67:1186. |
2. | de Alba MA, Villegas VM, Gold AS, Wildner A, Ehlies FJ, Latiff A, et al. Clinical findings and genetic expression profiling of three pigmented lesions of the optic nerve. Case Rep Ophthalmol Med 2015;2015:590659. |
3. | Al-Rashaed S, Abboud EB, Nowilaty SR. Characteristics of optic disc melanocytomas presenting with visual dysfunction. Middle East Afr J Ophthalmol 2010;17:242-5.  [ PUBMED] [Full text] |
[Figure 1]
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