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.