Mechanisms of optic disc swelling with diffuse choroidal melanomas: clinicopathologic correlations.

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Abstract
The clinical and histopathological findings in the eyes of 2 patients with diffuse malignant melanoma of the choroid are described. The tumors were minimally elevated and nonpigmented in the peripapillary area; both had an associated nonrhegmatogenous retinal detachment. Extension of the tumor into the region of the lamina choroidalis in each eye appeared to cause a localized constriction of the optic nerve and subsequent swelling of the optic nerve head. In addition, tumor infiltration of the nerve head was present in 1 eye. Ophthalmoscopic, fluorescein angiographic and ultrasonographic characteristics that differentiate between extensive tumor infiltration of the optic nerve head and swelling secondary to other causes are presented. The importance of appreciating this difference clinically is discussed.

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