Wang Fubin
Department of Ophthalmology, Shanghai Bright Eye Hospital, Shanghai, 200336, People's Republic of China.
Int Med Case Rep J. 2024 Feb 19;17:137-141. doi: 10.2147/IMCRJ.S444050. eCollection 2024.
Optic disc melanocytoma (ODMC) with peripapillary hyperreflective ovoid mass-like structures (PHOMS) is rare. This study reports a case of the characteristics of multimodal imaging and Minimum intensity projection (Min-IP) images.
A 25-year-old male patient was referred to our hospital due to the presence of a dark pigmented tumor located in the optic disc area of his left eye. The patient exhibited normal pupillary reactions and had a best corrected visual acuity of 1.0 (decimal) in both eyes. This patient underwent multimodal retinal imaging examination including color fundus photograph (CFP), B-scan ultrasonography, Fundus autofluorescence (FAF), SD-OCT (spectral-domain optical coherence tomography), OCTA (optical coherence tomography angiography), en-face Min-IP image and fluorescein angiography (FA).
CFP revealed a slightly elevated mass lesion in the inferior quadrant of the left optic disc, the lesion appeared black to dark brown in color. B-scan ultrasonography of the left eye confirmed the presence of a hyperechoic small dome-shaped lesion. Fundus autofluorescence (FAF) analysis revealed complete hypofluorescence in this area. SD-OCT (spectral-domain optical coherence tomography) and OCTA (optical coherence tomography angiography) with Min-IP were performed over the tumor and its surrounding areas. SD-OCT showed an elevated tumor mass arising from the optic disc with increased reflectivity. PHOMS appeared ovoid in shape on B-scan OCT image. PHOMS appeared peripapillary hyperreflective bright areas on en-face Min-IP image corresponding to PHOMS on B-scan OCT image. The fluorescein angiography (FA) showed the staining of PHOMS. A diagnosis of optic disc melanocytoma with PHOMS was established prompting the patient to be advised for regular follow-up.
The optic disc melanocytoma with PHOMS is a rare benign ocular lesion that requires minimal active intervention, but demands a lifetime follow-up. The multimodal imaging and Min-IP images have clinical diagnostic value.
伴有视乳头周围高反射卵形肿块样结构（PHOMS）的视盘黑素细胞瘤（ODMC）较为罕见。本研究报告了一例多模态成像及最小强度投影（Min-IP）图像特征的病例。
一名25岁男性患者因左眼视盘区域存在深色色素性肿瘤被转诊至我院。患者瞳孔反应正常，双眼最佳矫正视力均为1.0（小数）。该患者接受了多模态视网膜成像检查，包括彩色眼底照相（CFP）、B超扫描、眼底自发荧光（FAF）、谱域光学相干断层扫描（SD-OCT）、光学相干断层扫描血管造影（OCTA）、表面Min-IP图像及荧光素血管造影（FA）。
CFP显示左视盘下象限有一个略隆起的肿块病变，病变颜色呈黑色至深褐色。左眼B超扫描证实存在一个高回声小穹顶形病变。眼底自发荧光（FAF）分析显示该区域完全低荧光。对肿瘤及其周围区域进行了SD-OCT（谱域光学相干断层扫描）和带Min-IP的OCTA（光学相干断层扫描血管造影）检查。SD-OCT显示一个从视盘隆起的肿瘤块，反射率增加。PHOMS在B超OCT图像上呈卵形。在表面Min-IP图像上，PHOMS表现为视乳头周围高反射明亮区域，与B超OCT图像上的PHOMS相对应。荧光素血管造影（FA）显示PHOMS有染色。确诊为伴有PHOMS的视盘黑素细胞瘤，建议患者定期随访。
伴有PHOMS的视盘黑素细胞瘤是一种罕见的良性眼部病变，需要极少的积极干预，但需要终身随访。多模态成像和Min-IP图像具有临床诊断价值。
