Central retinal artery occlusion secondary to optic disk melanocytoma

To report a case of central retinal artery occlusion with cilioretinal artery sparing associated with an optic disk melanocytoma.

Retrospective observational case report.

A 29-year-old healthy male adult presented with sudden profound visual loss in the right eye since the past 3 days. His medical history was unremarkable with no history of antecedent trauma. Best-corrected visual acuity was 6/36 in the right eye and 6/6 in the left eye. The left eye was essentially normal. Right afferent pupillary defect was noted. Biomicroscopic examination of right fundus revealed an elevated, deeply pigmented, brown-black mass lesion over the optic disk, suggestive of melanocytoma. Other fundus findings were suggestive of central retinal artery occlusion with cilioretinal artery sparing. Clinical findings were confirmed on fundus fluorescein angiography, optical coherence tomography, ultrasonography, and visual field testing. Severe visual loss can occur because of retinal vascular occlusion in eyes with optic disk melanocytoma.

Rapid visual loss and retinal vascular occlusion associated with optic disk melanocytoma may not necessarily be caused by its malignant transformation. It may be caused by tumor necrosis itself. Although rare, it is still important to follow-up such patients closely to look for signs suggestive of malignant transformation.