DOI: https://doi.org/10.36347/sjmcr.2025.v13i11.047

Pages: 2858-2861

A 42-year-old female presented for routine examination. Fundus photography, Fluorescein Angiography (FA), and Optical Coherence Tomography (OCT) were performed to characterize a highly pigmented optic disc lesion. The patient was placed on an active annual surveillance protocol utilizing clinical examination and serial multimodal imaging. A jet-black, dome-shaped lesion on the left optic disc with feathered margins and preserved retinal vessels was documented (Fig. A, B). FA showed typical early hypofluorescence with late-phase filling (Fig. C). OCT confirmed the elevated structure with dense posterior shadowing (Fig. D). Over a two-year follow-up period, the lesion remained absolutely stable in size and morphology (Fig. E), confirming the benign diagnosis of ODM. Optic Disc Melanocytoma is a rare, typically stable tumor that poses a significant diagnostic challenge with choroidal malignant melanoma. While benign, the risk of rare malignant transformation and local vision-threatening complications mandates continuous vigilance. This case underscores the crucial role of active, long-term annual surveillance, particularly utilizing serial OCT and fundus photography, as the definitive and conservative management approach for clinically quiescent ODM.