Optical Coherence Tomography: Pathology Correlation of Optic Disc Melanocytoma

Objective: To correlate combined optical coherence tomography (OCT) and scanning laser ophthalmoscope (SLO) imaging to clinical and histopathologic characteristics of optic disc melanocytoma (ODM). Design: Retrospective, consecutive clinical case analysis. Participants: Twenty patients with ODM were evaluated. Testing: All underwent ophthalmic examinations including a best- corrected visual acuity, slit- lamp examination, dilated ophthalmoscopy, fundus photography with angiography, B- scan ultrasonography, and combined OCT and SLO imaging. Main Outcome Measures: One eye, treated by enucleation, was evaluated by pathologic analysis and was correlated to its combined OCT and SLO images. These findings were correlated to clinical and OCT information from 19 patients with ODM. Results: Histopathologic and combined OCT and SLO features included: disruption of the internal limiting membrane, disorganization of the retina (overlying the tumor), and visualization of the tumor's subretinal surface. Compressive and infiltrative changes in the optic nerve, peripapillary choroid, and retina were correlated directly to combined OCT and SLO images. To varying degrees, these histopathologic findings were seen on combined OCT and SLO. However, the pigment of the ODMs blocked OCT reflectance deep to the tumor's surface. Conclusions: This study demonstrated that OCT and SLO findings could be correlated directly with histopathologic characteristics. Imaging with OCT can be used to diagnose and correlate secondary retinal, superficial, and subretinal tumor characteristics.