Optic nerve invasion from an amelanotic peripapillary choroidal melanoma.
OBJECTIVE
To report an unusual case of an amelanotic optic nerve head melanoma.
This is a retrospective case report of an 81-year-old woman with a slowly enlarging amelanotic optic nerve head lesion. Histopathologic evaluation of the lesion after enucleation revealed a peripapillary choroidal melanoma. The lesion was highly atypical in that the patient's visual acuity was excellent despite the lesion's growth and the intraocular pressure did not differ from the fellow eye. The patient did have a history of primary open angle glaucoma, which may have rendered the optic nerve more susceptible to tumor invasion.


CONCLUSIONS
Optic nerve invasion by choroidal melanoma is a rare event, which is typically associated with poor visual acuity, elevated intraocular pressure, and large necrotic lesions; however, invasive melanoma with optic nerve invasion may occur in the absence of these classic findings.
From the Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Amy C
AC
Schefler
Lejla
L
Mutapcic
Timothy G
TG
Murray
Sander R
SR
Dubovy