This patient has a melanocytoma, which is a benign melanocytic tumor intrinsic to the optic nerve. There is pigmentation noted within the superonasal portion of the optic disc.
Learning Points:
Melanocytomas can sometimes enlarge and spread into the adjacent retina and choroid, and can very rarely undergo malignant transformation.
Most patients are asymptomatic, but some can develop visual field loss from compressive optic neuropathy.
These lesions should be periodically monitored for any signs of growth.
