Optical Coherence Tomography and Optical Coherence Tomography Angiography Features of Optic Disc Melanocytoma: Peripapillary Hyperreflective Ovoid Mass-like Structures, Perfusion Deficits, and Association With Vision Loss

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-08-20 DOI:10.1016/j.ajo.2025.08.040

Ruiheng Zhang, Jiaoyue Dong, Yitong Li, Haotian Wu, Li Dong, Xuhan Shi, Wenda Zhou, Heyan Li, Chuyao Yu, Hanqing Zhao, Yuhang Yang, Shanshan Wang, Yao Huang, Yueming Liu, Wenbin Wei

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引用次数: 0

Abstract

Purpose

To investigate the structural and vascular alternations of optic disc melanocytoma (ODM) using optical coherence tomography (OCT) and OCT angiography (OCTA).

Design

Retrospective case-series study.

Subjects

This study included 34 eyes diagnosed with ODM and 15 eyes with juxtapapillary choroidal melanoma (CM) who referred to Beijing Tongren Hospital from July 2019 to March 2025.

Methods

All subjects underwent OCT and OCTA cover the macula and optic nerve head (ONH) region.

Main Outcome Measures

The presence of peripapillary hyperreflective ovoid mass-like structures (PHOMS) and ONH vessel density were quantitatively analyzed and correlated with clinical parameters.

Results

ODM was characterized as a hyper-reflectivity anterior surface and dense posterior optic shadowing. PHOMS were observed in the 30 cases of ODM (88.2%), significantly more frequent than in fellow eyes (17.1%, P < .001). Epiretinal membrane was present in 20.6% of ODM cases, compared to fellow eyes (2.94%, P = .054). OCTA revealed reduced ONH vessel density in ODM eyes, predominately affecting the radial peripapillary capillary layer on the tumor surface, which resulted in 14 cases of localized radial peripapillary capillary atrophy and patchy nonperfusion areas on En-face images. Eyes with nonperfusion areas demonstrated worse visual acuity (LogMAR: 0.29 ± 0.36 vs 0.93 ± 1.29, P = .06), larger tumor basal diameter (3.9 vs 2.6 mm, P = .05), and tumor thickness (1.6 vs 1.1 mm, P = .03). No intrinsic tumor vasculature was identified within ODM, contrasting with the disorganized vascular network seen in all 15 cases of juxtapapillary CM.

Conclusions

ODM is associated with significant structural and vascular alterations, including PHOMS, ONH hypoperfusion, and eventually retinal nerve fiber layer atrophy. These features reflect both mechanical compression and ischemic injury to the optic nerve and can be used to assess visual prognosis. The absence of intrinsic tumor vasculature in ODM underscores its fundamental difference in biological behavior from juxtapapillary CM.

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视盘黑素细胞瘤的OCT和OCTA特征：PHOMS、灌注缺陷和与视力丧失的关系

应用光学相干断层扫描（OCT）和OCT血管造影（OCTA）研究视盘黑素细胞瘤（ODM）的结构和血管改变

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.