Melanocytoma of the optic disc - Clinical spectrum.

Melanocytoma of the optic disc, first described by Zimmermann, is a benign hamartoma arising from melanocytes in the disc.[1] Fig. 1a shows a typical dark-brown pigmented melanocytoma overlying and obscuring the disc with involvement of the adjacent choroid and retina. Over time, melanocytoma can lead to local compressive sequalae-like branch retinal artery occlusion [Fig. 1b] and ischemic optic neuropathy [Fig. 1c].[2] Rare, malignant transformation can occur in 1-2% of the cases with progressive increase in size and extensive involvement of the disc [Fig. 1d].[345] Cases with melanocytoma require yearly follow-up with photographic documentation to detect these changes early.[1]

Figure 1

Melanocytoma of the Optic Disc. (a) Typical dark-brown lesion overlying the disc with involvement of surrounding retina and choroid. (b) Melanocytoma with branch retinal artery occlusion. (c) Melanocytoma with compressive ischemic optic neuropathy. (d) Melanocytoma with extensive involvement of the disc and surrounding retina and progressive increase in size, suggestive of malignant transformation

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