Melanocytoma

This panel of three fundus photographs of the left eye taken over a 29 year span documents the behavior of a melanocytoma (yellow arrows) in a 71 year old. Three changes have occurred. The lesion has infiltrated the nasal neural rim of the optic nerve (green arrow). Note that the original picture from 1989 contains drusen (red arrows) that are not evident in the photograph from 2018. During the 18 year period between Panel A and B, serous retinal detachment overlying the lesion caused RPE atrophy (blue arrows). None of the available photographs captured the episode of fluid. The red “X” indicates an artifact from the picture taken in 1989. Melanocytomas are benign lesions that convert to melanoma approximately 1% of the time.