Experience in 13-year follow-up of a melanocytoma of the optic nerve head

Abstract

Thirteen years ago, a 35-year-old woman was found on routine ocular examination to have a pigmented tumor in her right eye, adjacent to the optic nerve head. The appearance of her fundus was suggestive of a melanocytoma. Her visual acuities were RE: 1.0 and LE: 1.0. Ultrasound examination revealed that the tumor diameter was 4.4 mm on the base and the maximal thickness was 2.7 mm. Fluorescein angiography showed a persistent hypofluorescence of the lesion. There were several additional examinations (e.g. determination of the visual field, measurement of the intraocular pressure, detection of visually evoked potentials, CT scan and MRI examination) to exclude a benign tumor of similar appearance, The patient underwent ocular examination every year. During the observation period a minor tumor enlargement occurred but there were no changes in the visual acuities. In the last two years minor signs of malignant transformation were found. The findings documented and illustrated here suggest that our methods were useful to differentiate the melanocytoma from a malignant melanoma, and no surgical interventions were needed to characterize or to remove the tumor. In addition, our patient has had good vision during the past 13 years.