Scanning Laser Ophthalmoscope-Optical Coherence Tomography (SLO-OCT) Evaluation of Optic Nerve Melanocytomas

Abstract

Abstract: : Purpose: : To evaluate the use of SLO-OCT as a tool in the noninvasive assessment of optic nerve melanocytomas. Methods: Six consecutive patients with optic nerve melanocytomas were evaluated with SLO-OCT. One case associated with central retinal vein occlusion and poor vision was cytopathologically confirmed to be a melanocytoma by fine needle aspiration biopsy. Results: SLO-OCT provided unique images of peripapillary and papillary pigmented lesions which corresponded to histopathological descriptions of melanocytomas. Optic nerve penetration, nerve fiber layer infiltration, and choroidal involvement were observed. Nerve fiber layer hyperreflectivity consistent with nerve fiber layer infiltration was observed in 4 cases. Displacement of normal RPE architecture or hyperreflectivity beneath the RPE suggesting choroidal involvement was noted in 5 cases. Displacement of normal optic nerve contour or hyperreflectivity of the optic nerve was observed in 5 cases. This finding was suggestive of optic nerve infiltration. Conclusions: SLO-OCT is a unique tool useful for the evaluation of melanocytomas. Detailed images demonstrate lesion characteristics previously only visible with ex-vivo histopathological analysis. The SLO-OCT provides noninvasive characterization of melanocytoma infiltration in the tissue layers, including optic nerve, nerve fiber layer, and choroidal involvement. Melanocytoma involvement within the choroid and optic nerve has not been imaged in vivo prior to SLO-OCT. This instrument offers the potential for evaluating in-vivo growth patterns of papillary and juxtapapillary pigmented lesions.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, S • melanocytes • imaging methods (CT, FA, ICG, MRI, OCT, RTA, S