Clinical and Spectral-Domain Optical Coherence Tomography Appearance of Optic Disc Melanocytoma: A New Classification and Differentiation from Pigmented Choroidal Lesions

Aims: The aim of this paper was to compare the features of both the classic, darkly pigmented and the atypical, more lightly pigmented optic disc melanocytoma with those of pigmented choroidal lesions. Methods: We analyzed the spectral-domain optical coherence tomography (SD-OCT) features of 9 eyes with optic disc melanocytoma and compared them with those of choroidal melanoma and nevus. Results and Conclusion: We identified 2 categories of SD-OCT findings in optic disc melanocytoma: (a) type 1, the typical, prominent, hyperpigmented lesion with SD-OCT findings of a hyperreflective, disorganized overlying retina and a posterior hyporeflective shadow, and (b) the less common, atypical, minimally pigmented type 2 lesion overlaid by a relatively well-organized retina that lacks a posterior hyporeflective shadow. Choroidal lesions were characterized by tumor confined beneath the clearly visible hyperreflective line of the photoreceptor and retinal pigment epithelium, with minimal disorganization of the overlying retina.