Multimodal Imaging of Optic Disc Melanocytoma–Associated Peripapillary Choroidal Neovascularization Treated with Ziv-Aflibercept

Abstract

We report a rare case of optic disc melanocytoma complicated by secondary peripapillary choroidal neovascularization (CNV) in a middle-aged patient. Fundus examination revealed a deeply pigmented optic disc lesion with an adjacent yellowish neovascular complex, subretinal fluid, haemorrhage, and hard exudates. Multimodal imaging confirmed active CNV adjacent to the melanocytoma. The patient was treated with a single intravitreal injection of ziv-aflibercept, resulting in improvement in visual acuity, restoration of foveal contour, and regression of the CNV. Optical coherence tomography (OCT) angiography demonstrated a mature vascular network consistent with regression, and the anatomical and visual outcomes remained stable through seven months of post-treatment follow-up. This case highlights the value of multimodal imaging in diagnosing this rare complication of optic disc melanocytoma and adds to the limited evidence supporting intravitreal ziv-aflibercept as a potential therapeutic option.