This document discusses various tumors and pseudotumors that can affect the optic disc, including congenital anomalies, pigmented tumors, tumors of the retinal pigment epithelium, vascular tumors, glial tumors, primary retinal tumors, and tumors invading from other sites. It provides examples of specific conditions like melanocytoma, hemangioblastoma, astrocytic hamartoma, and retinoblastoma. Diagnostic testing and treatment approaches are mentioned for some conditions. The conclusion emphasizes that while various tumors can involve the optic disc, most of these conditions are rare.

1. Leonidas Zografos
Lausanne
4th Thessaloniki International Vitreo-Retinal Summer School, 16-21. 6.2014, Electra Palace
Tumors and pseudotumors of the optic disc

2. Tumors and pseudo-tumors
of the optic disc
1. Congenital anomalies of the O.D.
2. Pigmented tumors and pseudo-tumors
3. Tumors of the pigment epithelium of the retina
4. Vascular tumors
5. Glial tumors of the optic disc
6. Tumors of the retina
7. Metastatic tumors
8. Leukemia and lymphoma
9. Optic disc invasion from primary tumors of the
optic nerve

3. Congenital anomalies
of the optic disc
Optic pit
Morning glory disc anomaly
Optic nerve coloboma

4. Prepapillary vascular anomalies
Arterial
loops
Venous
loops

5. Pigmented tumors and pseudo-tumors
Optic disc melanocytosis
Melanocytoma
Juxtapapillary melanoma
Primary melanoma of the optic disc

6. Optic disc
Melanocytomas

8. Edema of the optic disc 48%
Ophthalmoscopy +
Fluorescein
angiography +
24%
Ophthalmoscopy –
Fluorescein
angiography +
24%

9. ICG 2:08 ICG 50:48
Fluo 0:37

10. ICG 10:02
Fluo 0:50
07.2001
03.2003

11. Visual field defects
Acuate and
peripheral scotomas
27%
Enlargement of the
blind spot
16%

12. Visual field defects
Tubular vision 8%

13. Obs. per. 2 y.
Obs. per. 6 y. Obs. per. 8 y.
Optic disc
melanocytoma
Visual field defect

15. Melanocytoma of the
optic disc
Juxtapapillary CNV
Surgical excision

16. Obs. Period 8 years
Vis. Ac. 0.1
Melanocytoma of the
optic disc

17. Documented tumor growth
Obs. period ≥ 6 years 65%
Malignant transformation
Obs. period ≥ 10 years 5%

18. Juxtapapillary melanoma

19. Juxtapapillary melanoma
Proton Beam irradiation
Obs. Period. 1 year Vis. Ac. 04

20. 11.2004 10.2011 Vis. Ac. 0.2Vis. Ac. 1.0
Peripapillary melanoma

21. Epipapillary melanoma
Invasion of the optic disc

22. Retinoinvasive melanoma

23. Primary melanoma of optic disk

24. Tumors and pseudo-tumors of
the retinal pigment epithelium
Congenital hypertrophy of the RPE

25. Combined hamartomas
of RPE

26. Adenoma / Ca
of the juxtapapillary RPE

27. Adenoma / Ca
of the juxtapapillary RPE

28. Biopsy + proton beam irradiation
Obs. Period 7 years Vis. Ac. 0.01
Adenoma / Ca
of the juxtapapillary RPE

29. Vascular tumors
Cavernous hemangioma of the optic disc
Capillary hemangioma of the optic disc
Racemose hemangiomatasis
Wyburn-Mason Syndrome

30. Parapapillary hemangioblastoma
Sessile ExophyticEndophytic

31. M. 19 years
Isolated hemangioblastoma
Vis. Ac. 0.6

32. Obs. period 1 year Vis. Ac. 0.7
Obs. period 5 years Vis. Ac. 0.6
Laser 4 sessions

33. F. 30 years
Isolated hemangioblastoma
Vis. Ac. 0.4

34. Obs. period 2 years
Vis. Ac. 0.5
Laser +2 sessions

35. M. 12 years
Isolated hemangioblastoma
Vis. Ac. 1.0

36. Obs. period 3 years Vis. Ac. 0.01
Obs. period +2 m. Vis. Ac. 0.05
Obs. period +5 m. Vis. Ac. 0.4

37. 1 year post treatment Vis. Ac. 0.5
2 years post treatment Vis. Ac. 0.5
17 years post treatment Vis. Ac. 0.5
Laser 4 sessions

38. M. 16 years
v. Hippel – Lindau s.
Pheochromocytoma
19 years Vis. Ac. 0.1
Laser 4 sessions
Surgical excision

39. Vis. Ac. 0.2
1 m. post treatment Vis. Ac. 0.1
Photodynamic Therapy (PDT)
1.5 yeras post treatment Vis. Ac. LP

40. F. 35 years
v. Hippel – Lindau s.
Cerrebellar hemangioblastoma
Vis. Ac. 0.1

41. Proton beam radiotherapy
Vis. Ac. 0.1
6 month Vis. Ac. LP
7 years Vis. Ac. LP

42. Vis. Ac. 0.8 Vis. Ac. 0.8
Obs. period 10 years

43. M. 17 years
v. Hippel – Lindau s.
Cerrebellar hemangioblastoma
Vis. Ac. 0.1

44. Racemose hemangiomatasis
Wyburn-Mason Syndrome

45. Glial tumors of the optic disc
Astrocytic hamartoma
Noncalcified astrocytic hamartoma
Calcified astrocytic hamartoma

46. Astrocytic hamartoma
Calcified astrocytic hamartoma

47. Solitary progressive astrocytoma

48. Primary tumors of
the retina
Retinoblastoma

49. Choroidal metastasis
Invasion of the optic disc

50. Lymphomas
and
Leukemias

51. Optic disc invasion from
primary tumors of the optic nerve
Optic nerve glioma
Optic nerve meningioma

52. Conclusions
May be localized to the optic disc
All this conditions are rare or
extremely rare
Various
- Benign and malignant
- Primary and metastatic
- Tumors and pseudo-tumors