Japanese Journal of Ophthalmology

, Volume 57, Issue 1, pp 108–112 | Cite as

Hyperreflective dots surrounding the central retinal artery and vein in optic disc melanocytoma revealed by spectral domain optical coherence tomography

  • Akiko Okubo
  • Kazuhiko Unoki
  • Hiroshi Yoshikawa
  • Tatsuro Ishibashi
  • Munefumi Sameshima
  • Taiji Sakamoto
Clinical Investigation



To report findings of optic disc melanocytoma (ODM) obtained using spectral domain optical coherence tomography (SD OCT), with special reference to the central retinal artery and vein surrounded by hyperreflective dots.


Retrospective review of five eyes of five patients with ODM. Demographic information, ophthalmic examination including best-corrected visual acuity, dilated funduscopic examination, and SD OCT images were evaluated.


Dome-shaped, darkly pigmented tumors were seen ophthalmoscopically in the optic discs of all eyes. On OCT, the first branches of the central retinal artery and/or vein were well defined as oblique sections of tubular structures with a perivascular distribution of hyperreflective dots in the elevated retina (nerve fiber layer) over the tumor. The portions where these vessels turn toward the retina were displaced more anteriorly than those of eyes without ODM. Hyperreflective dots of various sizes were also observed in elevated retinas over the tumors, which shadowed and obscured the subjacent tissue in all eyes.


SD OCT provides higher definition images of ODM relating to the branches of the central retinal artery/vein, revealing anterior displacement of vessels and perivascular distribution of hyperreflective dots that suggest melanophages and/or tumor cells or proteins and/or lipid deposits.


Melanocytoma Optic disc Spectral domain optical coherence tomography Central retinal artery/vein Hyperreflective dot 


  1. 1.
    Zimmerman LE, Garron LK. Melanocytoma of the optic disc. Int Ophthalmol Clin. 1962;2:431–40.CrossRefGoogle Scholar
  2. 2.
    Shields JA, Demirci H, Mashayekhi A, Shields C. Melanocytoma of optic disc in 115 cases. The 2004 Samuel Johnson memorial lecture, part 1. Ophthalmology. 2004;2004(111):1739–46.Google Scholar
  3. 3.
    Shields JA, Demirci H, Mashayekhi A, Eagle RC, Shields CL. Melanocytoma of the optic disc: a review. Surv Ophthalmol. 2006;51:93–104.PubMedCrossRefGoogle Scholar
  4. 4.
    DeVeer JA. Melanotic tumors of the optic nerve head: a pathologic study. Arch Ophthalmol. 1961;65:536–41.PubMedCrossRefGoogle Scholar
  5. 5.
    Juarez CP, Tso MO. An ultrastructural study of melanocytomas (magnocellular nevi) of the optic disk and uvea. Am J Ophthalmol. 1980;90:48–62.PubMedGoogle Scholar
  6. 6.
    Mansour AM, Zimmerman L, La Piana FG, Beauchamp GR. Clinicopathological findings in a growing optic nerve melanocytoma. Br J Ophthalmol. 1989;73:410–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Antcliff RJ, Ffytche TJ, Shilling JS, Marshall J. Optical coherence tomography of melanocytoma. Am J Ophthalmol. 2000;130:845–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Shields CL, Perez B, Benavides R, Materin MA, Shields JA. Optical coherence tomography of optic disk melanocytoma in 15 cases. Retina. 2008;28:441–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Finger PT, Natesh S, Milman T. Optical coherence tomography: pathology correlation of optic disc melanocytoma. Ophthalmology. 2010;117:112–9.CrossRefGoogle Scholar
  10. 10.
    Kamisasanuki T, Uchino E, Sakamoto T. Choroidal neovascularization of optic disk melanocytoma treated with bevacizumab. Eur J Ophthalmol. 2012;22:503–5.CrossRefGoogle Scholar
  11. 11.
    Bolz M, Schmidt-Erfurth U, Deak G, Mylonas G, Kriechbaum K, Scholda C. Optical coherence tomography hyperreflective foci: a morphologic sign of lipid extravasation in diabetic macular edema. Ophthalmology. 2009;116:914–20.PubMedCrossRefGoogle Scholar
  12. 12.
    Ota M, Nishijima K, Sakamoto A, Murakami T, Takayama K, Horii T, et al. Optical coherence tomographic evaluation of foveal hard exudates in patients with diabetic maculopathy accompanying macular detachment. Ophthalmology. 2010;117:1996–2002.PubMedCrossRefGoogle Scholar
  13. 13.
    Uji A, Murakami T, Nishijima K, Akagi T, Horii T, Arakawa N, et al. Association between hyperreflective foci in the outer retina, status of photoreceptor layer, and visual acuity in diabetic macular edema. Am J Ophthalmol. 2012;153:710–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Font RL, Zimmerman LE, Armaly MF. The nature of the orange pigment over a choroidal melanoma: histochemical and electron microscopical observations. Arch Ophthalmol. 1974;91:359–62.PubMedCrossRefGoogle Scholar
  15. 15.
    Say EA, Shah SU, Ferenczy S, Shields CL. Optical coherence tomography of retinal and choroidal tumors. J Ophthalmol. doi: 10.1155/2011/385058.
  16. 16.
    Arima M, Yoshikawa H, Kagimoto T, Kohono R, Ishibashi T. A case of metastatic choroidal tumor simulating a choroidal melanoma. Jpn J Ophthalmol. 2011;55:312–4.PubMedCrossRefGoogle Scholar
  17. 17.
    Spaide RF, Koizumi H, Pozzoni MC. Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol. 2008;46:496–500.CrossRefGoogle Scholar
  18. 18.
    Tanabe H, Ito Y, Iguchi Y, Ozawa S, Ishikawa K, Terasaki H. Correlation between cross-sectional shape of choroidal veins and choroidal thickness. Jpn J Ophthalmol. 2011;556:614–9.CrossRefGoogle Scholar
  19. 19.
    Fujiwara A, Shiragami C, Shirakata Y, Manabe S, Iaumibata S, Shiraga F. Enhanced depth imaging spectral-domain optical coherence tomography of subfoveal choroidal thickness in normal Japanese eyes. Jpn J Ophthalmol. 2012;56:230–5.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2012

Authors and Affiliations

  • Akiko Okubo
    • 1
  • Kazuhiko Unoki
    • 1
  • Hiroshi Yoshikawa
    • 2
  • Tatsuro Ishibashi
    • 2
  • Munefumi Sameshima
    • 3
  • Taiji Sakamoto
    • 3
  1. 1.Unoki Eye ClinicKagoshimaJapan
  2. 2.Kyushu University Graduate School of Medical SciencesFukuokaJapan
  3. 3.Kagoshima University Graduate School of Medical Dental SciencesKagoshimaJapan

Personalised recommendations