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Central Retinal Vascular Obstruction Secondary to Melanocytoma of the Optic Disc
Jerry A. Shields, MD;
Carol L. Shields, MD;
Ralph C. Eagle, Jr, MD;
Arun D. Singh, MD;
Maria H. Berrocal, MD;
Jose A. Berrocal, MD
Arch Ophthalmol. 2001;119:129-133.
A 35-year-old black man developed abrupt visual loss in his left eye.
Ophthalmic examination revealed a deeply pigmented mass obscuring the optic
disc, hemorrhagic retinopathy, and signs of central retinal vascular obstruction.
Fluorescein angiography disclosed sluggish filling of the retinal blood vessels;
ultrasonography disclosed an acoustically solid mass in the optic nerve head.
Cytopathologic findings of a fine needle aspiration biopsy specimen demonstrated
probable benign tumor cells, but melanoma could not be excluded. Histopathologic
findings in the enucleated eye revealed a large, necrotic melanocytoma of
the optic disc and hemorrhagic necrosis of the retina secondary to obstruction
of the central retinal artery and vein. Melanocytoma of the optic nerve can
undergo spontaneous necrosis and induce central retinal vascular obstruction.
Abrupt visual loss in a patient with a melanocytoma does not necessarily imply
malignant transformation.
From the Ocular Oncology Service (Drs J. A. Shields, C. L. Shields,
and Singh) and the Department of Pathology (Dr Eagle), Wills Eye Hospital,
Thomas Jefferson University, Philadelphia, Pa; and the Department of Ophthalmology,
University of Puerto Rico, San Juan (Drs M. H. Berrocal and J. A. Berrocal).
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ABSTRACT
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