García-Arumí J, Salvador F, Corcostegui B, Mateo C
Department of Ophthalmology, Universidad Autónoma de Barcelona, Spain.
Retina. 1994;14(2):173-6. doi: 10.1097/00006982-199414020-00012.
Melanocytomas of the optic disk are heavily pigmented benign tumors that are most often discovered during routine examination, as they are classically asymptomatic. Although a slight impairment of visual acuity attributable to the tumor may occur in large tumors, acute profound visual loss is extremely unusual.
A case involving a 24-year-old woman with melanocytoma of the optic nervehead in the right eye, who experienced acute severe visual loss, an afferent pupillary defect, and optic nervehead edema, is discussed. Laboratory tests and serology for Toxoplasmosis, Syphilis, Borrelia, and Leptospira were performed.
The severe loss of vision, optic disc swelling, exudative detachment of the peripapillary retina, macular star, and spontaneous resolution in an otherwise healthy patient were all consistent with Leber's stellate idiopathic neuroretinitis. Results of serologic testing were not contributory.
This is the first report of Leber's neuroretinitis associated with melanocytoma of the optic nervehead, and should be included in the differential diagnosis of neuroretinitis. The possible mechanisms responsible for this association are discussed.
视盘黑色素细胞瘤是色素沉着严重的良性肿瘤，通常在常规检查中被发现，因为它们典型地没有症状。尽管大的肿瘤可能会导致因肿瘤引起的视力轻度损害，但急性严重视力丧失极为罕见。
讨论了一例涉及一名24岁右眼视神经乳头黑色素细胞瘤女性患者的病例，该患者经历了急性严重视力丧失、传入性瞳孔障碍和视神经乳头水肿。进行了弓形虫、梅毒、疏螺旋体和钩端螺旋体的实验室检查和血清学检测。
在一名其他方面健康的患者中，严重视力丧失、视盘肿胀、视乳头周围视网膜渗出性脱离、黄斑星芒以及自发缓解均与莱伯星状特发性神经视网膜炎相符。血清学检测结果无诊断意义。
这是首例与视神经乳头黑色素细胞瘤相关的莱伯神经视网膜炎报告，应纳入神经视网膜炎的鉴别诊断中。讨论了这种关联的可能机制。
