Melanocytoma of the Optic Disk in the Korean Population

Abstract

Optic disk melanocytoma in the Korean population tends to be superiorly located in the optic disk, and visual prognosis was excellent. Periodic ocular examination is warranted because 57% of patients were estimated to show tumor enlargement by 8 years of follow-up.

Melanocytoma of the Optic Nerve Head-A Diagnostic Dilemma

“…Rarely melanocytoma has been reported to present as an amelanotic lesion, which later acquired pigmentation. 3 In about 85% of the cases, melanocytomas extend over the margin of the optic disk to involve the adjacent choroid or retina. 4 Absence of lipofuscin deposition, retinal hemorrhages, retinal edema and subretinal fluid pointed against the diagnosis of malignant melanoma.…”

“…Relative afferent pupillary defect was present only in those with vision 20/50 or worse. 3 Visual loss in optic disk melanocytoma may be caused by local compression on the optic nerve, exudative retinal exudation, juxtapapillary choroidal neovascularization, tumor necrosis, central retinal vein obstruction or malignant transformation. 4 Visual field abnormalities reported include enlargement of the blind spot and nerve fiber bundle defects.…”

“…5 In the Korean population, Kaplan-Meier survival estimated that tumor growth was 0% at 1 year, 14% at 5 years, and 57% at 8 years. 3 Hence, slow increased in tumor size should not be regarded as a sign of malignant transformation. Rapid enlargement of the tumor can be caused by malignant transformation or ischemic necrosis of the tumor.…”

“…4 Increased vascularity on the surface with staining around the lesion, as in our patient, has been reported and was found to correlate with future tumor growth. 3 Magnetic resonance imaging (MRI) appearance of melanocytoma and uveal melanoma are similar; hence MRI was not performed for this patient. 8 Life long follow-up is required.…”

Melanocytoma of Optic Disc: Clinical Manifestations, Imaging Characteristics and Follow Up

“…[10], in another study minor tumor enlargement occurred in 11% of patients by 5 years and in 32% of patients by 10 years. Malignant transformation was documented in 2 patients (2%) [6].…”