Presumed optic disc melanocytoma in a young Nigerian: a diagnostic challenge

Abstract

Optic disc melanocytoma (ODM) is a rare, benign, deeply pigmented ocular tumor arising from melanocytes within the optic disc or from any part of the uvea. It occurs more in dark skinned individuals and females. We report a 17‑year‑old female who presented to our outpatient department with a history of poor distant vision from childhood, worse in the right eye. Ocular examination revealed visual acuity of 6/36 and 6/18 in the right and left eyes, respectively, which improved to 6/9 bilaterally with a pinhole. There was a relative afferent pupillary defect in the right eye, and a posterior segment examination of same eye showed a raised pigmented optic disc lesion occupying the inferior two-thirds of the optic disc and obscuring the lower disc margin. Both the anterior and posterior segments of the left eye were normal. A diagnosis of presumed ODM was made. Spectacles were prescribed, and the patient was counseled on regular follow‑up to monitor progression. ODM should be considered in patients presenting with a pigmented optic disc lesion. Regular follow‑up with fundus photography is advocated.

Keywords: Melanocytoma, optic disc, pigmented ocular tumor