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Optical coherence tomography angiography findings of an optic disc melanocytoma in a glaucoma eye

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Abstract

Purpose

To determine the optical coherence tomography angiography (OCTA) characteristics of a case of optic disc melanocytoma (ODM) associated with glaucomatous visual field and retinal nerve fiber layer (RNFL) defects in normal tension glaucoma.

Methods

The left eye of a 37-year-old female patient followed for a stable ODM for 10 years was investigated with OCT, OCTA, fluorescein (FA), and indocyanine green (ICGA) angiography. The ODM was unchanged, but a previously unknown inferotemporal neuroretinal rim loss and inferotemporal and superotemporal wedge shape glaucomatous RNFL thinning were seen with corresponding glaucomatous visual field defects. The intraocular pressure was 12 mmHg without treatment.

Results

In the area of the ODM, FA showed minimal vasculature, and week staining in the late phase, while ICGA showed no signal. In contrast, OCTA showed a dense vasculature in both the superficial and deep layers of the melanocytoma, which was clearly separated from the capillaries of the peripapillary retina. OCTA also showed reduced peripapillary perfusion in the areas of the glaucomatous RNFL bundle defects.

Conclusions

In the presented case of a stable ODM and newly detected normal tension glaucoma, OCTA provided more information on perfusion than FA and ICGA which are limited by the heavy pigmentation of the ODM. OCTA also showed a similarly decreased capillary perfusion in both RNFL bundle defects suggesting that the structural damage was related to glaucoma and not compression by ODM. These results suggest that OCTA may be a method preferred over conventional angiography in ODM cases.

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Author information

Author notes

  1. Yoshiyuki Kita and Gábor Hollό have contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Yoshiyuki Kita, Akiko Murai, Ritsuko Kita & Akito Hirakata

  2. Department of Ophthalmology, Semmelweis University, Budapest, Hungary

    Gábor Hollό

Authors
  1. Yoshiyuki Kita
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  2. Gábor Hollό
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  3. Akiko Murai
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  4. Ritsuko Kita
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  5. Akito Hirakata
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Corresponding author

Correspondence to Yoshiyuki Kita.

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Conflict of interest

Gábor Holló is a consultant of Optovue Inc and Zeiss. The other authors declare no conflict of interest.

Research involving human participants and/or animals

The Kyorin University Hospital Institutional Review Board for Human Research approved the study protocol, and the study conduct adhered to the tenets of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kita, Y., Hollό, G., Murai, A. et al. Optical coherence tomography angiography findings of an optic disc melanocytoma in a glaucoma eye. Int Ophthalmol 39, 677–682 (2019). https://doi.org/10.1007/s10792-018-0839-9

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  • DOI: https://doi.org/10.1007/s10792-018-0839-9

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