Successful treatment of melanocytoma associated choroidal neovascular membrane with intravitreal bevacizumab

Abstract

Melanocytoma of the optic disc is a benign melanocytic tumour that rarely causes visual impairment. We report a rare case of choroidal neovascularization (CNV) in association with optic disc melanocytoma and its response to intravitreal injection of the anti-vascular endothelial growth factor (VEGF), bevacizumab. The choroidal neovascular membrane regressed following a single intravitreal bevacizumab injection with formation of a scar. CNV associated with optic disc melanocytoma is rare. Intravitreal anti-VEGF treatment may be an effective treatment for CNV associated with optic disc melanocytoma.

Keywords: Anti-VEGF; Bevacizumab; Choroidal neovascular membrane; Melanocytoma; Optic disc.

Figure 1

Melanocytoma of the optic disc with a yellowish, elevated, well defined membrane overlying the papillomacular bundle surrounded by haemorrhage in the right eye.

Figure 2

Fluorescein angiogram of the right eye showing a lacy pattern in the early arterial phase, which increased in intensity and showed leakage in the late arteriovenous phase.

Figure 3

(A) Fluorescein angiogram of the right eye, pre-injection, showing increased intensity and leakage from the CNV in the late arteriovenous phase with an area of blocked fluorescence. (B) Optical coherence tomography of the right eye, pre-injection, showing subretinal fluid with a retinal thickness of 565 microns in the area nasal to the fovea. (C) Fluorescein angiogram of the RE one month postinjection showing only staining of the membrane with surrounding window defects. (D) OCT of right eye one month post-injection showing hyper-reflectivity corresponding to the scar with no residual fluid and a thickness of 290 microns in the corresponding area.