Transformation of optic disc melanocytoma into melanoma over 33 years.

sure was 8 mm Hg OU. Biomicroscopic examination revealed small, nongranulomatous keratic precipitates, 1 anterior chamber cell and flare, 1 to 2 vitreous cells and 1 haze, and multiple hypopigmented punctate lesions in the foveae in both eyes. These lesions demonstrated early staining on fluorescein angiography (Figure, A and B) and nodular increased reflectivity at the level of the retinal pigment epithelium on optical coherence tomography (Figure, E). Color fundus photographs were not available. After confirming negative results on chest radiography and syphilis serology, we initiated oral prednisone, 60 mg/d with an extended taper. At each successive visit, her visual acuity and symptoms improved. After completion of a 2-month prednisone taper, her visual acuity was back to baseline (20/40 OU), limited only by preexisting cataracts. The punctate lesions had nearly completely resolved on both examination and ancillary testing (Figure, C, D, and F).