Peripapillary choroidal melanomas. Extension along the optic nerve and its sheaths
H. F. Shammas and F. C. Blodi
We reviewed 26 cases of peripapillary melanoma, 21 (80.8%) of which
extended into the optic nerve or its meningeal sheaths. Most melanomas that
extended into the optic nerve were necrotic and of the mixed or epithelioid
cell type; all invaded the overlying retina and occurred in blind eyes with
secondary glaucoma. The extension of melanoma cells into the subarachnoidal
space was only influenced by the presence of the melanoma around the optic
nerve head (peripapillary). The prognosis of these patients was highly
dependent on the presence of orbital extension. A long piece of optic nerve
should be excised when eyes with peripapillary melanomas are enucleated.
