Neovascularized Optic Disc Melanocytoma Revealed by Progressive Visual Disturbance: A Multimodal Imaging Case Report

Abstract

Optic disc melanocytoma (ODM) is a benign pigmented tumor originating from melanocytes of the optic nerve head. Although usually stable, it may occasionally lead to visual impairment due to complications such as optic neuropathy, ischemia, or secondary neovascularization.

A patient presented with progressive visual disturbance in the right eye over three months. Best‑corrected visual acuity was 5/10 OD and 10/10 OS. Fundus examination revealed a pigmented optic disc mass with adjacent exudates. Optical coherence tomography showed optic disc edema with perilesional cystoid spaces and localized outer retinal atrophy. Fluorescein angiography demonstrated nasal peripapillary hyperfluorescence suggestive of neovascular activity. B‑scan ultrasonography revealed a 2.5‑mm oval hyper‑echogenic lesion centered on the optic disc without calcification but with mild Doppler vascularization extending through the lamina cribrosa.