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Year : 2020  |  Volume : 58  |  Issue : 4  |  Page : 322-323

Pigmented optic disc lesion: A melanoma masquerade

Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India

Date of Submission25-Jun-2020
Date of Decision20-Jul-2020
Date of Acceptance04-Aug-2020
Date of Web Publication16-Dec-2020

Correspondence Address:
Dr. V Muthukrishnan
No. 114, Inner Ring Road, Flat A4, Triumph Apartments, Arumbakkam, Chennai - 600 106, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_79_20

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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

How to cite this URL:
Shaikh ZM, Muthukrishnan V, Balla SC. Pigmented optic disc lesion: A melanoma masquerade. TNOA J Ophthalmic Sci Res [serial online] 2020 [cited 2022 Dec 7];58:322-3. Available from: https://www.tnoajosr.com/text.asp?2020/58/4/322/303661

  Introduction Top

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 Top

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

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  Conclusion Top

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.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Singh SR, Mehta A, Dogra M, Dogra MR. Melanocytoma of the optic disc-Clinical spectrum. Indian J Ophthalmol 2019;67:1186.  Back to cited text no. 1
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.  Back to cited text no. 2
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.  Back to cited text no. 3
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