探讨视盘黑色素细胞瘤(MCOD)的多模态影像学特征。

收集2010年8月至2022年3月就诊于首都医科大学附属北京同仁医院眼科中心确诊为MCOD患者21例(21只眼)的临床资料进行研究。其中，男性4例(4只眼)，女性17例(17只眼)，年龄28~82岁，平均年龄(53.1±14.6)岁。分别进行了彩色眼底照相、眼底自发荧光(FAF)、近红外反射成像(NIR－I)、荧光素眼底血管造影(FFA)、吲哚菁绿血管造影(ICGA)、频域光学相干断层扫描(SD－OCT)及光相干断层扫描血流成像(OCTA)检查，观察肿瘤的颜色、大小、位置、边界、是否继发视盘改变、与邻近视网膜或脉络膜的关系、肿瘤FAF特征、NIR－I特征、肿瘤荧光特征、视盘荧光特征、肿瘤的SD－OCT分型及OCTA血流特征。均采用频数和百分比进行描述。

彩色眼底照相检查中，MCOD呈墨黑色、颜色均匀且边界清晰者17例(17只眼)，占80%(17/21)。瘤体位于视盘颞侧者10例(10只眼)，占47.6%(10/21)。出现视盘继发改变者14例(14只眼)，占66.6%(14/21)。蓝光FAF检测MCOD均表现为完全的低自发荧光，占100%(21/21)。NIR－I检测MCOD均表现为边界清晰的高反射病灶且瘤体表面均呈平行纤维样或绒毛样外观，占100%(21/21)。FFA和ICGA检查MCOD均为低荧光，FFA早期可发现瘤体表面的细小血管者16例(16只眼)，占76.2%(16/21)。接受SD－OCT检查MCOD患者10例(10只眼)，呈典型表现者7例(7只眼)，占70%(7/10)；瘤体的不同部位分别呈典型和非典型表现者2例(2只眼)，占20%(2/10)，呈非典型表现者1例(1只眼)，占10%(1/10)。接受OCTA检查者4例(4只眼)，均可检测到表面瘤体浅层和深层血管网，占100%(4/4)。

多模态影像检查可以为MCOD的诊断提供重要的信息。MCOD在NIR－I和FAF检测中的特征性表现具有诊断和鉴别诊断价值。

To describe the multimodality image characteristics of melanocytoma of the optic disc (MCOD).

Patients diagnosed with melanocytoma of the optic disc at the Eye Center of Beijing Tong Ren Hospital affiliated to Capital Medical University from Aug 2010 to Mar 2022 were collected. Among them, there were 4 males (4 eyes), 17 females (17 eyes) with an average age of (53.1±14.6) years (ranged from 28 to 82 years old ). Color fundus photography, fundus autofluorescence (FAF), near-infrared reflectance imaging (NIR-I), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectralis spectral domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA) were performed, and the color, size, location and the border of the tumor, with or without the secondary change of the optic disc, the relationship between the tumor and the nearby retina or choroid, the FAF, NIR-I and the fluorescein characteristics of the tumor and the optic disc, the categories of SD-OCT findings and the tumor vasculature in OCTA were observed and recorded. All data was described as frequency and percentage.

In color fundus photography, 17 cases (17 eyes) of MCOD were featured as a well-defined tumor with uniform jetblack color, accounting for 80% (17/21), and 10 cases (10 eyes) of the tumor located at the temporal portion of the optic disc, accounting for 47.6% (10/21). 14 cases (14 eyes) were accompanied by secondary changes of the optic disc to various degrees, accounting for 66.6% (14/21). In blue-light FAF imaging, all MCOD showed complete hypoautofluorescence, accounting for 100% (21/21). In NIR-I imaging, all MCOD were represented as well-defined hyper reflectance lesion, and the surface of the tumor with a nearly parallel fibrous or villous appearance, accounting for 100% (21/21). MCOD of patients were showed mainly hypofluorescence in FFA and ICGA imaging. There were 16 cases (16 eyes) with small blood vessels on the surface of the tumor in the early stage of FFA, accounting for 76.2% (16/21). Among 10 cases (10 eyes) performed SD-OCT imaging, there were 7 cases (7 eyes) with typical appearance, accounting for 70% (7/10), 2 cases (2 eyes) with both typical and atypical appearance in different parts of the tumor, accounting for 20% (2/10), 1 case (1 eyes) with atypical appearance, accounting for 10% (1/10). Among 4 cases (4 eyes) performed OCTA imaging, they were found tumor vasculature both in superficial and deeper layers, accounting for 100% (4/4).

Multimodality image detection could provide an important information in the diagnosis of MCOD. MCOD has characteristic features in NIR-I and FAF, which is of great value to the diagnosis and differential diagnosis.