American Journal of Ophthalmology
Volume 138, Issue 6 , Pages 964-969, December 2004

Melanocytomas of the optic disk

This study was presented in part at the annual meeting of the Swiss Society of Ophthalmology, Lugano, Switzerland, September 2003, and at the annual meeting of the Macula Society, Las Vegas, Nevada, February 2004.

  • Leonidas Zografos, MD

      Affiliations

    • Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland
    • Corresponding Author InformationInquiries to Leonidas Zografos, MD, Hôpital Ophtalmique Jules Gonin, 15, av. de France-Case postale 133, 1000 Lausanne 7, Switzerland; fax: +41 21 626 8889
    • ,
  • Chantal Bornet Othenin-Girard, MD

      Affiliations

    • Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland
    • ,
  • Laurence Desjardins, MD

      Affiliations

    • Institut Pierre et Marie Curie, Service d’Ophtalmologie, Paris, France
    • ,
  • Ann Schalenbourg, MD

      Affiliations

    • Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland
    • ,
  • Line Chamot, MD

      Affiliations

    • Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland
    • ,
  • Sylvie Uffer, MD

      Affiliations

    • Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland

Accepted 5 July 2004. published online 19 November 2004.

Purpose

To evaluate the various forms of clinical presentation, the potential of growth, the risk of functional loss and the possibility of malignant transformation of optic disk melanocytomas in European patients.

Design

Retrospective observational case control study.

Methods

Evaluation of 37 cases of optic disk melanocytomas identified in the computer files of the ocular oncology unit of Jules Gonin Hospital to determine the clinical presentation of these tumors and the risk of complications.

Results

The tumor was asymptomatic in 28 cases. Visual acuity was normal in 26 cases, subnormal in 10 cases, and in one case it was reduced to 0.1. Visual field defects were observed in 19 cases; the size and extent of the tumor and the degree of papilledema appeared to influence the severity of the visual field defect. Tumor growth was demonstrated in 6 of the 9 cases in which follow-up was for at least six years. In two cases there was presumed malignant transformation that was treated by accelerated proton beam radiotherapy.

Conclusions

Melanocytomas in white Europeans and those of European derivation are rarely symptomatic, have only a moderate effect on visual function and show a low rate of progression over long observation. The risk of tumor progression, although sometimes occurring as much as several years after the initial diagnosis, justifies a cautious approach with long-term regular surveillance of these patients.

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PII: S0002-9394(04)00845-1

doi:10.1016/j.ajo.2004.07.004

American Journal of Ophthalmology
Volume 138, Issue 6 , Pages 964-969, December 2004

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