Objective To investigate the clinical manifestation and follow-up of melanocytoma of the optic disc. Methods Retrospective case series study was taken to study the clinical data of the cases with melanocytoma of the optic disc at Peking Union Medical College Hospital from 1978 to 2007. The examination included direct and indirect ophthalmoscopy, fundus photography, fundus fluorescein angiography (FFA), fundus indocyanine green angiography (ICGA), optical coherence tomography (OCT) and B-scan. The clinical manifestation and the outcome in follow-up period were analyzed. Results Ten cases aged 31-58 years (mean 43 years) were included in this study. Among them, 9 cases were male, 1case was female. All cases were unilateral involved, 5 cases were right eye, 5 cases were left eye. The distribution of the visual acuity was follows: light perception in 2 eyes, 20/200 in one eye, 20/20 or above in 7 eyes. The tumor mass at the optic disc with extensive serous detachment of retina was detected on B-scan in one eye. The benign melanocytoma was diagnosed by vitreous fine needle biopsy for this eye. In other case, the tumor was found to be enlarged, visual field defect deteriorated, pigment granules appeared in the vitreous adjacent to the tumor during on year follow-up period. On the patient request, enucleation was performed to rule out the malignancy of the tumor. Pathologic study showed that the tumor cells were active, but benign state. The tumor size and visual acuity in other eight eyes remained stable in the follow-up period with one to 18 years (mean 3.5 years). On FFA and ICGA, bilateral choroidal nevi were found in one eye. Conclusions Melanocytoma of the optic disc is a benign tumor that rarely causes visual impairment. However, visual acuity may be impaired due to enlargement of the tumor or necrosis in tumor. It is important to follow-up every case with melanocytoma of the optic disc as long as pessible.%目的 探讨视乳头色素细胞瘤的临床表现和随诊观察的结果.方法 回顾性系列病例研究.回顾分析1978至2007年间确诊的10例视乳头色素细胞瘤患者的临床资料.检在项目包括直接、间接眼底镜及裂隙灯前置镜查眼底,眼底照相,荧光素眼底血管造影(FFA),吲哚氰绿眼底血管造影(ICGA),相干光断层扫描(OCT)及B超扫描等.结果 10例患者中男性9例、女性1例,年龄30～58岁,平均43岁.10例均为单眼患病,左、右眼各5例.视力:光感2例,0.1者1例,其余7例均为1.0以上.1例有广泛视网膜下积液,B超扫描显示视乳头上有一肿物,经玻璃体细针吸取肿瘤组织后活检,诊断为良性色素细胞瘤.1例,在1年的观察中,肿瘤隆起增加,视野缺损扩大,邻近玻璃体色素颗粒增多,为除外恶性变,应患者要求摘除眼球.病理诊断为良性视乳头色素细胞瘤,肿瘤细胞生长活跃,但无恶性改变.其他为8例色素性隆起肿物,位于视乳头上或有部分越过边界,在随诊1.0～18.0年(平均3.5年)的观察中,视力未减退,肿瘤无变化.其中1例经FFA或ICGA检查发现为双侧脉络膜斑痣.结论 视乳头色素细胞瘤是眼内良性肿瘤,一般不影响视力但应长期随诊观察.
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