Multimodal imaging features of optic disc melanocytoma in a Chinese population

AIM: To characterize the multimodal fundus imaging features of optic disc melanocytoma (ODM) in a Chinese population. METHODS: This retrospective observational case series included patients diagnosed with ODM at Beijing Tongren Hospital between January 2015 and December 2025. Demographic data and multimodal fundus imaging findings were reviewed and analyzed. RESULTS: Sixty-nine patients (69 eyes) were included. The mean age at presentation was 47.8±12.1y (range, 17–70y), with a female predominance (71.0%). All cases were unilateral. Clinically, lesions appeared as elevated gray-to-black masses involving the optic disc. The mean basal diameter was 3.84 mm, and the mean tumor thickness was 1.68 mm. Associated findings included optic disc edema (69.6%), retinal nerve fiber layer thinning (56.5%), perivascular sheathing (33.3%), retinal edema or exudation (5.8%), epiretinal membrane (7.2%), vitreous seeding (13.0%), and peripapillary hyperreflective ovoid mass-like structures (PHOMS, 19.0%). On optical coherence tomography (OCT), the tumor-retina interface was classified into three patterns: smooth hyperreflective (27 eyes), nodular hyperreflective (34 eyes), and honeycomb-like hyperreflective (9 eyes). CONCLUSION: Chinese patients with ODM demonstrate clinical and multimodal imaging characteristics comparable to those reported in other ethnic populations. However, tumors in this cohort are slightly larger, and are associated with two relatively uncommon complications: PHOMS and epiretinal membrane. Three distinct OCT tumor-retina interface patterns were identified, which may reflect variations in tumor-retinal interaction.