Coexisting Optic Disc Melanocytoma and Pituitary Adenoma

To report a rare case of optic disc melanocytoma coexistent with pituitary adenoma.

Ophthalmological examination with perimetry and magnetic resonance imaging (MRI) of the brain and orbits was done.

A 42-year-old woman presented with complaints of progressive diminution of vision in the right eye of 6 weeks' duration. Visual acuity in the affected right eye was 6/60 and in the left eye it was 6/6. On examination, a brown-black lesion was noted over the optic nerve head in the right eye. On perimetry, the visual field was constricted in the right eye and a superior altitudinal defect was found in the left eye. MRI of the brain and orbits revealed a pituitary adenoma with suprasellar extension. The patient underwent endoscopic transphenoidal pituitary adenoma excision with uneventful recovery. Three months following surgery, visual acuity improved to 6/6 in both eyes with partial visual field recovery and was maintained at 10 months of follow-up. There was no recurrence or metastasis.

A high degree of suspicion is required to screen for possible coexistent orbital or central nervous system pathology in cases of optic disc melanocytoma with disproportionate signs or symptoms.