Role of angiography in diagnosis of juxtapapillary melanoma

A 39-year-old male with a recent onset scotoma in the right eye was referred to us with a diagnosis of optic disc melanocytoma. A brown-colored tumor involving the nasal aspect of the disc was noted on the color photograph (A). Fluorescein angiography (B) and en-face optical coherence tomography angiography (OCTA) (C) showed fine vascularity within the tumor. Cross-sectional OCTA (D) showed flow signal within the superficial part of the tumor, confirming that the vascularity was localized to the tumor [Fig. 1]. Optic disc melanocytoma typically exhibits hypofluorescence throughout the angiogram.[1] However, the presence of intrinsic vascularity in this case confirmed the diagnosis of juxtapapillary melanoma. The patient underwent brachytherapy with a notched ruthenium-106 plaque.Figure 1: (a): Color photograph showing a brown-colored tumor involving the nasal aspect of the disc. (b): Late venous phase of fluorescein angiography showing fine intrinsic vascularity. (c): Enface OCTA (manual segmentation by modifying the inner and outer segmentation limits in each cross sectional OCTA, scanning the complete extent of the tumor) showing fine intrinsic vascularity. (d): Cross-sectional OCTA showing flow signals within the tumor (blue lines denote the inner and outer segmentation limit modified manually to include the visible thickness of the tumor)Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.