PMC5778552_01
Fundus photograph of the left eye depicting a brownish-black mass overlying the optic disc and obscuring its inferior and temporal margins
IJO-66-140-g001.jpg
PMC5778552_01_IJO-66-140-g001.jpg
F1
The mass spared the superior and nasal margins of the optic disc [Fig. 1].
Swept-source optical coherence tomography radial line raster imaging of the mass. (a) The mass is seen as a thumb such as lesion overlying the optic disc with a hyperreflective vitreal surface, smooth moderately reflective internal architecture (arrow) followed by a dense optical shadow. (b) The mass has superficial nodules toward the vitreal side. Note that the choroidal and outer retinal architecture are well-maintained, but the retinal nerve fiber layer appears thickened (arrowheads). (c) Optical coherence tomography image showing scattered hyperreflective dots within the mass. The retinal nerve fiber layer appears thickened (arrowheads). (d) The junction between the mass and the overlying retinal layers is clearly visible (arrow)
IJO-66-140-g002.jpg
PMC5778552_01_IJO-66-140-g002.jpg
F2
The lesion had a densely hyperreflective vitreal border that was irregular and nodular [Fig. 2]. The overlying retinal nerve fiber layer appeared compressed with localized evidence of neuronal edema. There were a few hyperreflective foci within the tumor, and the retinal nerve fiber layer was thickened [Fig. 2].
Swept-source optical coherence tomography angiography images of the optic nerve head region scanned over an area of 4.5 mm x 4.5 mm. (a) The imaging slab is set at 130 um below the surface. A meshwork of thin vessels, measuring 1,961,323 mum2 in the area, can be seen at this level. (b) The en-face optical coherence tomography projection shows the mass simulating a ladybird due to its strategic relationship with retinal vessels and the optic disc
IJO-66-140-g003.jpg
PMC5778552_01_IJO-66-140-g003.jpg
F3
OCT slab [Fig. 3]. On en-face OCT projection, there was a ladybug-like appearance of the mass with "black dots seen on the round body of the insect" [Fig. 3].